People with rheumatoid arthritis may be more likely to have neck arteries narrowed by plaque, a new study shows.
The study focuses on the carotid arteries, which run up through the neck, bringing blood to the brain.
Using ultrasound imaging, the researchers viewed the carotid arteries of 98 people with rheumatoid arthritis (RA) and 98 people without it. The two groups were matched for age, sex, and ethnicity.
Rheumatoid arthritis patients were three times as likely to have plaque-narrowed carotid arteries as those without it, the study shows.
Compared with the general public, people with RA die prematurely, mainly from heart disease, write Mary Roman, MD, and colleagues in the Annals of Internal Medicine.
Roman works in the cardiology division at Cornell University's Weill Medical College.
Plaque and Rheumatoid Arthritis
The researchers noted participants' risk factors for heart disease, including high blood pressure, family history of heart disease, and diabetes.
The group without RA included more smokers and people with high blood pressure. Even so, the RA group had triple the odds of having plaque-narrowed arteries.
Among the RA patients, 44% had plaque-narrowed carotid arteries. So did 15% of the comparison group without RA.
Participants without RA who had high blood pressure stopped taking their blood pressure medication for three weeks before their carotid arteries were studied. Blood pressure medicine wasn't interrupted for anyone with RA.
About the RA Patients
The rheumatoid arthritis patients were 20-83 years old (average age: 35). On average, they had been diagnosed with RA 12 years before the study.
Compared with people without RA, plaque-narrowed arteries were more common in RA patients of all age groups, "particularly among the younger patients," the researchers write.
However, not all RA patients had plaque-narrowed carotid arteries. The artery problem was more often seen in patients taking TNF therapy, biologic drugs that target an inflammatory protein called tumor necrosis factor (TNF).
Roman's team doesn't blame anti-TNF drugs for that pattern. Instead, the researchers say patients taking TNF therapy may have more severe rheumatoid arthritis, which could affect risk of artery disease.
Inflammation's Role?
Possibly, inflammation related to RA is also tied to risk of atherosclerosis (plaque-hardened blood vessels), the researchers write, noting that they haven't proven that theory.
They call for "aggressive control" of rheumatoid arthritis -- along with curbing other risk factors for heart disease -- "because chronic inflammation is probably a driving force for premature atherosclerosis."
Since participants' arteries were only checked once, the study doesn't show how artery disease progressed over time. Future studies should probe how rheumatoid arthritis speeds up atherosclerosis and how to stop that process, write Roman and colleagues.
http://www.webmd.com/rheumatoid-arthritis/news/20060221/rheu matoid-arthritis-artery-risk-tied
[QUOTE=Lynn49]
However, not all RA patients had plaque-narrowed carotid arteries. The artery problem was more often seen in patients taking TNF therapy, biologic drugs that target an inflammatory protein called tumor necrosis factor (TNF).
Roman's team doesn't blame anti-TNF drugs for that pattern. Instead, the researchers say patients taking TNF therapy may have more severe rheumatoid arthritis, which could affect risk of artery disease.
[/QUOTE]
"May have more severe RA"? Couldn't they check? How convenient, not to blame TNFs for the pattern, even though the study showed not all RA patients had the problem.
Maybe they should be on Zetia....or Vytorin.....or just take daily aspirin, like those who did so well in the other study.....
Or the beasties are spreading!
Does it seem like I see bacteria everywhere?
;-)
Pip
my doctor keeps telling me that he doesn't like the biologics. He has patients with bad reactions, one is his receptionist. I met her 3 years ago when i started going to him and she said she was on remicade and how wonderful it was, she is now going to work with a cane and very sick because she had a horrible reaction and infection to remicade. She said she likes prednisone and will probably be on it forever.
But, biologics worry me. I have such bad reactions to medications and food, they would have to be out a lot longer for me to decide to take it.
I had to have a CT scan for sinus problems when I was in my late 30's. This was before RA and I have always had low BP and no cholesterol problems (still have low BP and no cholesterol problems) Of course since I work in medical records I ordered myself a copy of the CT. Even back then I had plaque in my carotid arteries. Maybe plaque causes RA? Hmm, it makes me dizzy to think of all the variables. Of course I had 5 joint surgeries in a about 4 years before I had RA. Maybe I had mild RA before. Oh no, I am dizzy again. Did they also control for exercise/activity level? I expect that in general, people with RA might be more sedentary than people without RA, all other things (race, age, gender) being equal. Is it enough of a difference to explain the differences in plaque buildup in each group? I dunno. I would hope the researchers looked into that as well.