Heart Risk Often Overlooked in RA Patients

Cardiovascular disease risk not always considered in rheumatoid arthritis patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Rheumatoid arthritis (RA) patients are at a higher risk of developing cardiovascular disease, yet not all doctors are considering the added heart risk, a new study reveals.

The immune system attacks tissue in RA, causing inflammation in joints. That inflammation also appears to affect other regions of the body, increasing the risk of heart disease.

"Exercise and eat plenty of fruits and vegetables to increase heart health."

Eric Matteson, MD, chairman of Mayo Clinic's Rheumatology Division and co-author of the study, said that conventional predictors of risk are not adequate for estimating heart risk in RA patients. He urged awareness of the heightened risk among doctors caring for RA patients, asking them to consider methods for measuring and reducing cardiovascular risk in those who do not appear to be more likely to develop heart disease.

Previous research has suggested that heart disease may be the reason that RA patients are at an increased risk of dying.

During the study, researchers followed 525 men and women over the age of 30 who were diagnosed with RA between 1988 and 2007. None had a history of heart disease. Investigators reviewed medical records from the National Institutes of Health-funded Rochester Epidemiology Project.

This allowed them to evaluate the true RA frequency and success of treatment in Olmsted County, Minnesota.

Researchers then used two standard cardiovascular risk assessments -- both Framingham and Reynolds -- to estimate each patient's risk of developing heart disease over the next decade. During about eight-and-a-half years of follow up, 84 patients developed cardiovascular disease.

As compared to the Framingham score, women with RA were found to be at twice the heart risk, while men were at a risk 65 percent higher than predicted. The Reynolds risk assessment also was found to be inaccurate for RA patients.

Older patients over age 75 also were at a cardiovascular risk three times higher than predicted, while those with positive rheumatoid factor, determined through a blood test to confirm RA, also had more adverse heart events than were anticipated.

Additional studies are still needed to pinpoint the exact mechanism for the increased heart disease risk among RA patients, and to determine methods to best estimate cardiovascular risk.

The study, funded by grants from Pfizer Inc. and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, was recently published in The American Journal of Cardiology.

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Review Date: 
May 22, 2012
Last Updated:
August 1, 2012