By Will Boggs, MD
NEW YORK (Reuters Health) – Patients with rheumatoid arthritis experience more cardiovascular events than other patients, independent of the usual cardiovascular risk factors, according to a report in the December 2001 issue of Arthritis and Rheumatism.
In the first study of cardiovascular risk factors in rheumatoid arthritis that focuses on both fatal and nonfatal events, Dr. Inmaculada del Rincon and colleagues, from University of Texas Health Science Center at San Antonio, Texas, compared the incidence of cardiovascular events in persons with and without rheumatoid arthritis after adjusting for traditional risk factors.
Among 236 rheumatoid arthritis patients in the ORALE (Outcome of Rheumatoid Arthritis Longitudinal Evaluation) study, the authors report, the incidence of cardiovascular events was 5.9 events overall per 100 person-years and 5.2 new events per 100 person-years.
In contrast, the report indicates, 4635 individuals in the San Antonio Heart Study (SAHS) experienced an overall rate of 0.75 events per 100 person-years and 0.59 new events per 100 person-years.
After adjustment for age and gender, the cardiovascular event incidence rate ratio was almost 4 times higher in the RA group than in the SAHS group, the researchers note.
Multivariate analysis that accounted for age, sex, diabetes, cigarette smoking, systolic blood pressure, and body-mass index confirmed that the incidence of cardiovascular events in the RA patients was more than triple that in the population-based SAHS group.
"Even though we found that the risk of cardiovascular events is independent of traditional cardiovascular risk factors, it is still important to implement risk modification measures," Dr. del Rincon told Reuters Health. "Further research is needed in determining the factors associated with cardiovascular risk in rheumatoid arthritis patients so that meaningful recommendations can be made. If inflammation is found to play a major role in atherosclerosis, this would extend the current indications for the aggressive suppression of the inflammation in these patients."