The association of hemorrhoids with the incidence of heart failure: a nationwide cohort study.

Background: Studies evaluating the association between hemorrhoids and heart failure (HF) have been limited. We aimed to evaluate the association between increased incidence of HF and the presence of hemorrhoids using a population-based longitudinal cohort. Methods: We included 356,033 participants in this study, derived from health screening data collected between 2003 and 2007 from the South Korean health screening cohort database. Hemorrhoid presence was identified as having a minimum of two claims based on the International Classification of Diseases, Tenth Revision (ICD-10) code I84. Propensity score matching (PSM) was used to assign participants to two groups according to the presence and treatment of hemorrhoids. The primary outcome was the incidence of HF, defined as having two or more claims based on the ICD-10 code I50. Results: Among the participants, the presence of hemorrhoids was observed in 24,363 (6.8%) individuals. Over a median follow-up period of 13.33 years (interquartile range, 10.4-16.26), 55,167 cumulative cases of HF (15.5%) occurred. In multivariate analysis, the group with hemorrhoids consistently showed a higher incidence of HF compared to those without hemorrhoids, both before [hazard ratio (HR): 1.073; 95% confidence interval (CI): 1.028-1.121] and after PSM (HR: 1.073; 95% CI: 1.018-1.131). Regarding surgical procedures/treatments for hemorrhoids, participants who underwent surgical procedures or treatment for hemorrhoids showed a lower incidence of HF before PSM (HR, 0.919; 95% CI: 0.845-1.001) and after PSM (HR, 0.941; 95% CI: 0.880-1.001). Conclusions: Our study revealed a significantly increased incidence of HF among participants with hemorrhoids. Therefore, it should be noted that when hemorrhoids are present, the risk of developing HF in the future may be increased.