Having gallstone disease may increase your risk of coronary heart disease, according to new research.

Gallstone disease, one of the most common and costly gastrointestinal disorders in the United States, has similar risk factors as coronary heart disease, including diabetes, obesity, high cholesterol, high blood pressure and poor diet.

In a meta-analysis of seven studies consisting of 842,553 participants and 51,123 cases of coronary heart disease, researchers found that a history of gallstone disease was linked with a 23 percent increased risk of developing coronary heart disease.

“Our results suggest that patients with gallstone disease should be monitored closely based on a careful assessment of both gallstone and heart disease risk factors,” said Lu Qi, M.D., Ph.D., study senior author and professor of epidemiology at Tulane University in New Orleans, Louisiana. “Preventing gallstone disease may also benefit heart health.”

In a separate analysis of 269,142 participants in three other studies, the researchers found coronary heart disease occurred more often with a history of gallstone disease because of the shared risk factors. Moreover, the increased risk was similar between women and men.

Interestingly, in the three studies, participants with a history of gallstone disease who were otherwise healthy — were not obese or diabetic and didn’t have high blood pressure — had a greater risk of coronary heart disease than participants that had these conditions.

The researchers didn’t identify why gallstone disease and coronary heart disease were linked. But one theory is that gallstones may affect bile acid secretion, which has been related to cardiovascular risk factors. Gut microbiota has also been related to cardiovascular disease.

Understanding the factors that link gallstones and coronary heart disease and clinical trials to assess the effects of the factors on cardiovascular health are essential for applying the research findings to clinical practice, Qi said.

The study is published in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology.