Arthritis May Signal Heart Danger Ahead

Rheumatoid arthritis raises heart disease risk and those with early menopause may face extra risk

/ Author:  / Reviewed by: Dominique Brooks, M.D Beth Bolt, RPh

(RxWiki News) Arthritis has been shown to double the risk of cardiac events, according to the Arthritis Foundation. Rheumatoid arthritis and early menopause may put the heart in even greater jeopardy.

Several studies have found a link between rheumatoid arthritis and cardiovascular disease. Some say that inflammation is the common culprit.  While inflammation can help the body’s defenses, it damages joints and other tissue in people with rheumatoid arthritis. And for those with heart disease, it triggers atherosclerosis.

Recent research from the Mayo Clinic confirms that patients whose rheumatoid arthritis (RA) is more severe are more likely to have heart problems than those who have a less severe condition or do not have RA.

"Treat rheumatoid arthritis early on to help prevent heart problems."

Eric Matteson, MD, chair of rheumatology at the Mayo Clinic in Rochester, Minnesota, served as senior author on several recent studies connecting rheumatoid arthritis with coronary disease.

In one investigation, Dr. Matteson and his colleagues analyzed data on 526 patients with RA. At baseline — when a patient’s RA was first reported — there was no association with an increase in cardiovascular events. Over the average follow-up of about seven years, the risk of cardiovascular events increased as a patient’s RA became more severe.

"One thing that we learned in particular in this study is that the high disease burden on the joints in the first year of disease already is a very strong predictor of cardiovascular disease subsequently, and that seems to be mitigated as time goes on if the disease burden can be reduced too," Dr. Matteson said in a press release.

Beyond managing traditional risk factors such as high cholesterol, high blood pressure and stopping smoking, Dr. Matteson stresses the importance of getting the rheumatoid arthritis under control.

He told dailyRx News, “The more severe and active the disease, the higher likelihood of developing heart disease. Hence the importance of patients working closely with their doctor to control the disease. Also, it means that patients and doctors should pursue cardiovascular risk evaluation and management even if there seems to be no sign of heart disease.”

In related research, Dr. Matteson and fellow investigators observed that women with RA and early menopause had a higher likelihood of getting heart disease. In this study, scientists reviewed data on 600 women with RA — 199 of whom experienced early menopause. After an average follow-up close to 12 years, about 36 percent of the early menopause women had cardiovascular disease versus about 33 percent in the women who did not have early menopause.

“Further investigation is needed to determine the role that female sex hormones play in the development of CVD in women with RA,” the authors wrote.

Dr. Matteson noted that women who have had multiple children, especially seven or more, were also at higher risk of cardiovascular disease compared with women who had menopause at a normal age or had fewer children.

Scientists also discovered that a common virus called cytomegalovirus caused alterations in the immune system that show up as increased amounts of specific inflammatory proteins in patients with RA.

“The presence of these proteins is associated with increased risk of heart disease,” Dr. Matteson told dailyRx News.

Another highlight from recent Mayo Clinic findings revealed that RA patients had a great likelihood of developing a high uric acid level (or hyperuricemia). This condition proved to be an indicator of peripheral arterial disease but not for cardiovascular disease. 

These Mayo Clinic studies were presented at the American College of Rheumatology annual meeting at the end of October in San Diego.

Review Date: 
October 26, 2013
Last Updated:
October 28, 2013