Plantar Fasciitis as a Potential Early Indicator of Elevated Cardiovascular Disease Risk.

Background Plantar fasciitis is characterized by heel pain and is often associated with extended periods of walking or standing, improper footwear, and biomechanical imbalances. This condition primarily affects the bottom of the foot, particularly the area where the heel meets the arch. Despite its prevalence, the potential systemic effects, especially the relationship with cardiovascular disease (CVD) risk factors, require further illumination. This study explores the association between chronic plantar fasciitis and elevated C-reactive protein (CRP) levels in individuals with cardiovascular risk factors. Methods A cross-sectional study of 400 patients with foot or ankle pain was initially assessed clinically and with ultrasound or MRI scans. After excluding those with confounding factors for elevated CRP, 295 patients with concurrent diabetes, hypertension, or dyslipidemia were analyzed. We investigated the correlation between plantar fasciitis and elevated CRP levels, defined as >1 mg/L, in the context of cardiovascular risk assessment. Results The study indicated that nearly half of the patients suffering from foot or ankle pain were diagnosed with plantar fasciitis, accounting for 47.8% of cases. A statistically significant association was observed between plantar fasciitis and elevated CRP levels (p=0.035). Furthermore, a substantial correlation was found between high BMI and plantar fasciitis, but no gender-specific disparity was noted. Elevated CRP levels were significantly associated with diabetes, hypertension, and dyslipidemia. Discussion A definitive cause-and-effect relationship between plantar fasciitis and systemic inflammation has not been established; our study suggests that chronic plantar fasciitis may be more than a localized condition and could be indicative of systemic inflammation, which is known to be a factor in atherosclerosis and CVD. The observed correlation between increased CRP levels and plantar fasciitis suggests that plantar fasciitis might be a clinical indicator of systemic inflammation and could improve the assessment of CVD risk. Conclusions Elevated levels of CRP, associated with chronic plantar fasciitis, suggest a link to systemic inflammation, which could elevate the risk of CVD. Identifying plantar fasciitis as a marker for systemic inflammation in patients with CVD risk factors, including diabetes, hypertension, and dyslipidemia, underscores the importance of thorough cardiovascular evaluations in individuals with persistent heel pain. Further longitudinal and interventional research is essential to substantiate these preliminary findings and understand their impact on CVD risk management and treatment.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Faisal Specialist Hospital and Research Center Research Ethics Committee issued approval RAC#2241149. The research project was conducted according to the ethical principles contained in the Declaration of Helsinki (2000), the WHO Operational Guidelines for Ethical Committees that Review Biomedical Research (2000), the International Ethical Guidelines for Biomedical Research Involving Human Subjects (2002), and the policies of the Research Advisory Committee (RAC) at King Faisal Specialist Hospital and Research Centre, as well as the laws of the Kingdom of Saudi Arabia. The data collected and all files related to the research project were locked in a secure location in the Department of Family Medicine. They were made available to the RAC as per the guidelines of KFSH&RC. The study proposed no additional interventions for patients. The proposal was primarily about collecting data, and no clinical interventions were planned. The study posed no risk to patients; the risk-benefit ratio was considered favourable. The information was kept completely anonymous. The datasheet did not use the patients' names or medical record numbers. Instead, UPN codes were used to ensure confidentiality and privacy. Despite this, verbal consent was obtained from every patient in the study as information was taken from their medical records. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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