Effects of Heart Risk Factors Differ in Arthritis

A recent study report published in the Annals of the Rheumatic Diseases suggests that patients of rheumatoid arthritis face varying risks of cardiovascular disease from traditional risk factors compared to patients without rheumatoid arthritis. While certain factors increase the risk, others confer a lower risk on the patients.

Cardiovascular disease is the main cause of death in several patients with rheumatoid arthritis. However, it is not yet clear what impact traditional factors of cardiovascular risk have in rheumatoid arthritis. To clarify this impact, Dr. Sherine E. Gabriel and colleagues from the Mayo Clinic studied a total of 1206 patients; 50% of them had rheumatoid arthritis while the other 50% did not.

The researchers looked at the frequency of traditional cardiovascular risk factors in the study population and determined the effect these risk factors had on certain specific cardiovascular outcomes including heart attack, heart failure, and cardiovascular death in the two groups. Both groups had similar initial prevalence of cardiovascular risk factors.

The volunteers with rheumatoid arthritis were followed for an average period of 15 years while the other group was followed for 17 years. During this period, the researchers found that the rheumatoid arthritis patients were significantly more likely to lose weight while being highly unlikely to develop abnormal lipids levels, such as high or low density cholesterol.

The two groups also differed in the impact that gender, smoking status, and personal cardiac history had on them. In particular, rheumatoid arthritis patients did not face that much of an increase in cardiovascular risk due to male gender, current smoking, and personal cardiac history as did those without rheumatoid arthritis.

“These results indicate that cardiovascular disease prevention strategies focused solely on controlling traditional cardiovascular risk factors may not have the same impact in persons with rheumatoid arthritis as would be expected based on estimates from the general population,” the investigators said.

According to the researchers, patients with rheumatoid arthritis might have competing mechanisms playing a role in the development of cardiovascular disease, which might be the reason behind the weaker effect of certain cardiovascular risk factors in such patients. They expressed the need for additional research for the detection of such underlying risk factors of rheumatoid arthritis-associated cardiovascular disease so that therapeutic approaches could be devised.

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