Jiyoul Yang ¹ Sun-Hyung Kim ¹ Jae Kyeom Sim ² Seonhye Gu ³ Seok Jeong Won ⁴ Dae-Hwan Bae ⁵ Jun Yeun Cho ¹ Ki Man Lee ¹ Kang Hyeon Choe ¹ Hyun Lee ⁶ Bumhee Yang ^7* Kyung Hoon Min ^8*

• ¹ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
• ² Department of Pulmonology, Allergy and Critical Care Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
• ³ Department of Epidemiology and Health Informatics, Korea University, Seoul, Republic of Korea
• ⁴ Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
• ⁵ Department of Cardiology, Chungbuk National University College of Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
• ⁶ Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
• ⁷ Chungbuk National University College of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
• ⁸ Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea

Background Although the association between tuberculosis (TB) and cardiovascular disease (CVD) has been reported in several studies and is explained by mechanisms related to chronic inflammation, few studies have comprehensively evaluated the association between TB and CVD in Korea. Methods Using the Korea National Health and Nutrition Survey (KHNANES), we classified individuals according to the presence or absence of previous pulmonary TB was defined as the formal reading of a chest radiograph or a previous diagnosis of pulmonary TB by a physician. Using multivariable logistic regression analyses, we evaluated the association between the 10-year atherosclerotic cardiovascular disorder (ASCVD) risk and TB exposure, as well as the 10-year ASCVD risk according to epidemiological characteristics. Results Among the 69,331 participants, 4% (n = 3,101) had post-TB survivor group. Comparing the 10-year ASCVD risk between the post-TB survivor and control groups, the post-TB survivor group had an increased 10-year ASCVD risk in the high-risk group (40.46% vs. 24.00%, P < 0.001). Compared to the control group, the intermediate- and high-risk groups had also significantly increased 10-year ASCVD risks (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.23 and OR 1.69, 95% CI 1.59–1.78, respectively) in the post-TB survivor group. In the association of CVD among post-TB survivors according to epidemiologic characteristics, age (adjusted OR [aOR] 1.10, 95% CI 1.07–1.12), current smoking (aOR 2.62, 95% CI 1.32–5.17), a high family income (aOR 2.47, 95% CI 1.32–4.62), diabetes mellitus (aOR 1.92, 95% CI 1.20–3.07), and depression (aOR 2.15, 95% CI 1.10–4.19) were associated with CVD in the post-TB survivor group. Conclusions Our study findings suggest a higher 10-year ASCVD risk among TB survivors than healthy participants. This warrants long-term cardiovascular monitoring and management of the post-TB population.