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Limited data exist on the cardiovascular (CV) implications of IBD, but a higher prevalence of CV disease (CVD) has been observed compared to the general population, resulting in increased mortality risk. This review examines the pathophysiology and risk factors linking IBD to CVD, highlighting several key mechanisms: The \u201clipid paradox\u201d in active IBD, arterial stiffness and endothelial dysfunction, proinflammatory cytokine activity, gut microbiota dysbiosis, and drug-induced myocardiopathy. The main findings include information about IBD patients exhibiting a higher incidence of CVD compared to the general population, independent of traditional risk factors. Chronic inflammation, altered lipid profiles, and gut microbiome imbalances play a significant role in heightened CV risk. Routine CV risk assessment should be considered during clinical assessment, to integrate into IBD management. 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