In a recent study entitled “The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis,” researchers suggest that traditional cardiovascular risk factors such as hypertension are an additional risk for cardiovascular disease morbidity in rheumatoid arthritis (RA) patients. In light of their findings, the authors underscore the need to monitor these risks in the RA population. The study was published in the open-access journal Plos One.
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting more than 1.3 million Americans, of which 75% are women. The disease is characterized by inflammation of the joints, ultimately leading to their destruction. However, the disease also develops extra-articular features and one of the most common complications of RA is cardiovascular disease. RA patients have 48% and 60% higher risk of morbidity and mortality due to cardiovascular disease (CV), respectively. While the pro-inflammatory environment of RA was suggested as the underlying cause for higher CV risk, other conditions – hypertension, type 2 diabetes (T2D), smoking, hypercholesterolaemia, obesity and physical inactivity – can also promote it.
In this study, the authors determined how individual CV risk factors impact the cardiovascular outcomes of RA patients. The team performed a retrospective literature search and review for studies reporting CV morbidity and mortality in RA patients that were associated with traditional CV risk factors. The databases used were Pre-Medline, Medline, Scopus and Cochrane and the search included reports published until March of 2013.
The team searched for traditional CV risk factors, including hypertension, type 2 diabetes (T2D), smoking, hypercholesterolaemia, obesity, and physical inactivity. Disease outcomes included myocardial infarction, CV morbidity due to myocardial infarction, angina, heart failure, stroke, and peripheral arterial disease and CV mortality.
The authors recognized that although they detected inconsistencies among studies, their meta-analyses retrieved that hypertension, T2D, smoking, hypercholesterolaemia and obesity significantly increased the risk for CV disease in RA patients. Notably, the authors noted that the magnitude of impact is equivalent in RA patients as it is in the general population. As such, the authors’ highlight that RA patients should be submitted to the same managing CV risk measures as the non-RA patients.
