As If Painful, Inflamed Joints Weren't Enough ...

Risk of heart attack increases quickly after rheumatoid arthritis is diagnosed

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

(RxWiki News) Just one year after a patient has been diagnosed with rheumatoid arthritis (RA), the risk of having a heart attack is 60 per cent higher.

Findings from a recent Swedish study following 7,469 women found that the average age of diagnosis for RA was 56 with 71 percent of patients being women. A total of 67 percent of patients had a positive rheumatoid factor (RF), an immunological marker found in a number of acute and chronic conditions. Both rheumatoid-factor positive and rheumatoid-factor negative were associated with an increased heart attack risk.

An RA diagnosis increased the risk of ischaemic heart disease by 50 percent for one to 12 years after diagnosis. Even more troubling, the risk of an acute heart attack rose by 60 percent for one to 12 years after diagnosis.

The longest follow-up in the study was 12 years with a median follow-up just over four years.

"Our research underlines the importance of clinicians monitoring patients diagnosed with rheumatoid arthritis for an increased risk of heart problems, in particular heart attacks," said study author Marie Holmqvist. "It is also very clear that more research is needed to determine the mechanisms that link these two health conditions."

There are approximately 1.3 million rheumatoid arthritis sufferers in the United States, about 75 percent of whom are women. Rheumatoid arthritis damages the joints, most commonly in the hands, feet, and cervical spine. Inflammation can also affects other organs and systems in the body such as the skin, lungs (fibrosis), kidneys (amyloid protein deposits), and cardiovascular system (increased risk for heart attack and stroke, as well as fibrosis and pericarditis). A clinical diagnosis can be made on the basis of symptoms, physical exam, radiographs, x-rays and lab tests. There are many prescription medications used to treat rheumatoid arthritis such as hydroxychloroquine (Plaquenil®), chloroquine (Aralen®), leflunomide (Arava®), and methotrexate (Rheumatrex ®). Non-pharmacological treatment includes psychical therapy, orthoses, and nutritional therapy but these do not stop progression of joint destruction. Analgesia (painkillers) and anti-inflammatory drugs, including steroids, are used to suppress the symptoms, while disease-modifying antirheumatic drugs (DMARDs) are required to inhibit or halt the underlying immune process and prevent long-term damage. Recently the newer group of biologics, such as abatacept (Orencia®), adalimumab (Humira®), etanercept (Enbrel®), infliximab (Remicade®), and rituximab (Rituxan®) have increased treatment options.

Reviewed by: 
Review Date: 
December 9, 2010
Last Updated:
March 9, 2011