Lower Death Risk in Heavier RA Patients?

Rheumatoid arthritis patients with higher BMI had lower death risk than those with normal BMI

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Both rheumatoid arthritis and obesity can contribute to heart problems. But when the two conditions are combined, the picture may get a little foggier.

In a recent study, rheumatoid arthritis patients who were overweight or obese had a lower risk of heart-related death and death from all causes, compared to patients of normal weight.

However, overweight or obese patients had a higher risk of other complications, including greater pain and total joint replacement.

"Control your weight if you have rheumatoid arthritis."

Generally, obesity boosts the risk of many health problems, including diabetes and heart disease. Obesity has also been linked to an increased risk of rheumatoid arthritis.

Frederick Wolfe, MD, of the National Data Bank for Rheumatic Diseases and the University of Kansas School of Medicine, and Kaleb Michaud, PhD, of the University of Nebraska Medical Center, set out to study the impact of body fat on the risk of death in people with rheumatoid arthritis.

They found that patients who were overweight or obese had a 20 percent lower risk of both cardiovascular death (death from heart-related problems) and death from all causes, compared to people of normal weight.

Patients who were underweight had a 90 percent higher risk of death.

Even though obesity was associated with a lower risk of death, it was also linked to other complications. Compared to patients of normal weight, obese rheumatoid arthritis patients were:

  • 4.8 times more likely to have diabetes
  • 3.4 times more likely to have high blood pressure
  • 1.3 times more likely to have a heart attack
  • 1.4 times more likely to get a joint replacement
  • 1.9 times more likely to have work disability

In addition, obese patients had higher levels of pain, medical costs that were $1,683 greater and household incomes that were $6,481 lower than normal-weight patients.

Since obesity usually increases the risk of complications in rheumatoid arthritis, it is not entirely clear what these findings mean.

More research is needed to see if overweight and obese patients always have a lower risk of death than their normal-weight counterparts.

For their research, Dr. Wolfe and Dr. Michaud studied the risk of death in 24,535 patients with rheumatoid arthritis. The patients were divided into four categories based on body mass index (BMI) - a measure of body fat using height and weight.

The BMI categories were as follows:

  • less than 18.5, or underweight
  • 18.5 to 24.9, or normal weight
  • 25 to 29.9, or overweight
  • 30 or more, or obese

The study was published September 27 in Arthritis Care & Research, a journal of the American College of Rheumatology.

Reviewed by: 
Review Date: 
October 3, 2012
Last Updated:
July 18, 2014