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Haemorrhoids

Haemorrhoids came with a 7 percent higher rate of heart failure in 356,033 Koreans. Among those treated, the direction reversed

Over a median 13.3 years the hazard ratio was 1.073. In the group that had surgery or treatment it was 0.941 — and that second interval touches 1, which is the part worth being careful about.

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In short

In a population-based cohort of 356,033 participants in the South Korean national health screening database with screening data from 2003 to 2007, of whom 24,363 (6.8 percent) had haemorrhoids, 55,167 cases of heart failure (15.5 percent) accumulated over a median 13.33 years of follow-up, and the group with haemorrhoids had a higher incidence of heart failure both before propensity score matching (hazard ratio 1.073, 95% CI 1.028 to 1.121) and after it (HR 1.073, 95% CI 1.018 to 1.131), while participants who underwent surgical procedures or treatment for haemorrhoids showed a lower incidence that did not reach significance (HR 0.941, 95% CI 0.880 to 1.001 after matching).

Key takeaways

  • 356,033 participants were drawn from the South Korean national health screening cohort with screening data from 2003 to 2007.
  • Haemorrhoids were present in 24,363 participants, or 6.8 percent.
  • Over a median 13.33 years of follow-up, 55,167 cases of heart failure occurred — 15.5 percent of the cohort.
  • The hazard ratio for heart failure with haemorrhoids present was 1.073 (95% CI 1.018 to 1.131) after propensity score matching.
  • Among participants treated or operated on for haemorrhoids the hazard ratio was 0.941 (95% CI 0.880 to 1.001) after matching, an interval that includes 1.
  • Haemorrhoids were identified from at least two claims carrying ICD-10 code I84, and heart failure from at least two claims carrying I50.
  • An observational association of this size does not establish that haemorrhoids cause heart failure.

A hazard ratio of 1.073 is a 7 percent relative increase, and on its own it would not be worth reporting. What makes this cohort worth reading is the second comparison inside it: the participants who were treated for their haemorrhoids did not carry the excess.

The two numbers

1.073 vs 0.941

hazard ratio for heart failure — haemorrhoids present, against haemorrhoids treated or operated on — after propensity score matchingWoo HG et al., Annals of Translational Medicine, 2025

The first figure is statistically significant and stable: 1.073 before matching with a confidence interval of 1.028 to 1.121, and 1.073 after matching with 1.018 to 1.131. The second is not significant. Its interval runs from 0.880 to 1.001, which includes 1, and a result whose interval includes 1 has not excluded no effect. The study describes it as a lower incidence. The honest phrasing is that it points that way and stops short of showing it.

What a marker is, and why it fits better here

There is no mechanism by which dilated veins at the anal canal would strain the heart over thirteen years. Run the causal claim in the other direction and it becomes more plausible immediately: whatever raises venous pressure, stiffens vessels or accompanies chronic straining and obesity could produce both conditions independently.

What the claims definition can and cannot see

Both conditions were identified from insurance claims: at least two entries under ICD-10 code I84 for haemorrhoids, at least two under I50 for heart failure. Requiring two claims is a reasonable guard against a single speculative code, and it still means the study counted diagnoses rather than disease. Severity, grade, symptom duration and whether the haemorrhoids were bleeding are all invisible.

The practical consequence is narrow and worth stating plainly. Nobody should be treated for haemorrhoids in order to protect their heart. The finding that survives is smaller and still useful: a patient presenting with haemorrhoidal disease is, on Korean national data, slightly more likely than average to carry cardiovascular risk that has not been looked for — which is an argument for checking blood pressure at that visit, not for operating.

Sources

  1. 1

    Woo HG, Park JY, Park MS, Song TJ

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

    Annals of Translational Medicine 2025;13(2):14

    doi:10.21037/atm-24-218 · PMID:40438520

    https://doi.org/10.21037/atm-24-218