Rheumatoid Arthritis and Your Heart | Arthritis Information

 

People with rheumatoid arthritis understandably focus on caring for their joints. But their most serious health risk involves their heart. Compared to the general population, rheumatoid arthritis patients have a significantly increased risk of heart attack and stroke and a shorter life expectancy. Here are some of the findings from recent studies:

• Heart attacks are twice as common among women with rheumatoid arthritis as among those without the disease.
• Atherosclerosis ("hardening of the arteries”) starts early and progresses more rapidly in people with rheumatoid arthritis.
• Carotid artery blockages (a risk factor for stroke) are three times more common in people with rheumatoid arthritis than in people without the disease (44% vs. 15%).
• Cardiovascular events, such as heart attack and stroke, occur about 10 years earlier in people with rheumatoid arthritis.
• Mortality is higher among rheumatoid arthritis patients after a first heart attack.
• Blood vessel damage is often already apparent at the time of rheumatoid arthritis diagnosis.
• Heart attacks in rheumatoid arthritis patients are more likely to be silent or to occur without the typical symptoms, and they more often result in sudden cardiac death.
• Congestive heart failure (weakening of the heart’s pumping ability) is more common among people with rheumatoid arthritis.

Researchers have identified several links between rheumatoid arthritis and cardiovascular disease. Inflammation is believed to be the most important of these. Cardiologists now understand that inflammation plays a crucial role in the onset of atherosclerosis. They believe that an injury to the inner lining of the arteries (the endothelium) triggers an immune response, sending immune system cells rushing to repair the damage.

But in chronic inflammatory states such as rheumatoid arthritis, the immune response doesn’t shut off after the injury heals. The accumulating immune system cells attract deposits of cholesterol, blood platelets, cellular debris, and calcium, which clump together to form plaque. As plaque deposits grow, they restrict blood flow through the artery. If the plaque ruptures, clots can break away and travel to the heart or brain, where they may cause a heart attack or a stroke.

Bottom line advice: What Can You Do? The relationship between rheumatoid arthritis and the heart is complex, and rheumatologists still have a great deal to learn about how to reduce the risk of cardiovascular disease among people who have rheumatoid arthritis. For now, it’s important to do everything possible to reduce the traditional risk factors for heart disease and stroke: smoking, obesity, a sedentary lifestyle, high blood pressure, high cholesterol, and diabetes.

Getting regular exercise and losing extra pounds (even a 5–10% weight reduction is beneficial) will help your joints as well as your heart. Monitor your blood pressure and have your cholesterol levels checked regularly. Also, ask your physician about the possibility of taking a low-dose aspirin each day to reduce your risk of cardiovascular disease. In addition, the cholesterol-lowering medications known as statins—atorvastatin (Lipitor) and others—not only help the heart, but also have modest beneficial effects on rheumatoid arthritis -related inflammation. If your doctor hasn’t already suggested one of these, you might ask about it.

Ok... not to hijack the thread it is kinda related... I have some concern about the suggestion to take Lipitor.  One of the side effects of Lipitor (and more common that is reported, I believe) is joint pain and problems.  I have known people who have experienced this side effect. Good thoughts, Patti.  Cholestrol lowering drugs do not allow the liver to regenerate if need be. we also have to be careful with some of the meds we take---they can also affect our heart. we get it at every corner I guess!Patti, that's exactly why I refused to take statins.  My (former) primary care doctor got pretty pushy and said "do you want to have a heart attack and die?" and I told him that I'd rather have that than more joint and muscle pain.  The look on his face was priceless. What a great article!!! I completely agree with it too. I've had 2 heart attacks and since the RA med's, I've had a terrible time with my BP and my Cholesterol. I do have other contributing factors, but when I took the med's, (I've stopped all the biologic's and the MTX), my heart worked overtime so much that it's now enlarged because of the exertion it faced. My lungs are scared and they contribute that to the long use of MTX. I still take BP med's and Rate med's and cholesterol drugs, but not near as much as I did when I was on the RA med's. I'll take the pain from the RA over the fear of heart attack any day. So much of the drugs prescribed for this horrible disease are pure poison to some folk's. Unfortunately, I'm one of those folk's.


I think that anyone who see's a Rheumatologist, should see a cardiologist also. If for anything else, do it as a "precaution".

Love and God Bless,
Vicki Well, it's no surprise that if we have a disease running rampant in our body that some part of us will eventually give out. Adding more pharamaceuticals doesn't seem like a great solution. Try fish oil. As well as controlling inflammation it thins your blood so it can lower blood pressure I am seen at the Cleveland Clinic for my RA and over 2 years ago they mentioned this to me.  In fact, RA pts are followed for hypertension, cardiac concerns, etc because of this link.  It is rather daunting to know that the pain and inflammation of RA is not in itself all that we have to deal with.  My mom succumbed to a heart attack after several heart attacks and a debilitating stroke that left her last six months unable to walk or talk.  She had RA, too.  She's been gone nearly 20 years and I know she didn't have the good meds that we have today.  Mostly coated aspirin.  Nothing that stopped the RA's progression.*shudder* All this stuff scares me.Me too, MrsA...especially with having to stay here for my 3 yr old and be able to participate in his life. I pray they find something soon...It sure is scary! I was on enbrel ( 3 shots total ) and then I developed an arrythmia in my heart. I stopped the enbrel but now I have this arythmia thing for the rest of my life. I also spoke to a woman that had near cardiac failure on enbrel and she was very young!

Thats not even one of the side effects listed---it just says if you have ever had heart failure---don't take---it doesn't say it could cause the heart failure! If I could--I would sue them. And I am not one of those people that is sue-happy but the rest of my life is affected from this now. I would of never gone on that med had I known this. Even my rheumy thinks they should of tested enbrel more--she hates the biologics because she gets scared for her patients and doesn't want to be the one that prescribes something to them that could potentially hurt them.When it is all said and done, what we all need to be concentrating on rather than the meds, is taking really good care of our bodies, getting our cholesterol levels down as naturally as possible and with meds if all else has failed to bring it down, to eat a healthy diet, to get daily activity and exercise in whatever form we can get it in. (everyone can swim) keeping our stress down, drink lots of water and working hard on getting the inflammation under control. These are all key. Not just one of them, all of them. [QUOTE=lorster]When it is all said and done, what we all need to be concentrating on rather than the meds, is taking really good care of our bodies, getting our cholesterol levels down as naturally as possible and with meds if all else has failed to bring it down, to eat a healthy diet, to get daily activity and exercise in whatever form we can get it in. (everyone can swim) keeping our stress down, drink lots of water and working hard on getting the inflammation under control. These are all key. Not just one of them, all of them. [/QUOTE]

 

And stop smoking.   There are many things we can do to take care of ourselves.  If you have to take cholesterol lowering drugs, even though you've lost weight and are following a low choles diet, don't think you've failed.  I have to take high BP meds even though I've lost weight, use less sodium and have little stress, that's just the way it is. We don't know  all the drug side effects.  We know which side effects showed up in the studies prior to release of the meds to the public.  There's always the outside chance that there will be other unknown side effects and we take our chances.  The meds haven't caused the problems to my heart and lungs.  RA has taken it's toll on them and for me that's why it's so important to take my meds and hope for remission.  I chose to take them knowing that there would be side effects and even unknown side effects. Linda

Any yes Lindy, I forgot to add the weight issue. That is a major reason for inflammation. I'm continually working on mine. I hate it, but it is a reality that I constantly need to address.

Don't forget being UNDER weight. It's an odd one, but being under weight is incredibly unhealthy as well.

 

I was a naughty girl my senior year of high school and first year of college. I just kinda....didn't eat. Weighed a whopping 116lbs at 5'6" (I should be a full figured girl with my bone structure)  That was the last time before this flare, that I was in a lot of pain and had hand swelling. Once I gained weight, I had about 2 years of normal life.

 

And then I got slightly over weight. And now here I sit!! Soooo trying to lose weight, I just REALLY REALLY suck at it!!!

 

So either way you go on the scale, you're going to run into problems. So DON'T starve yourself!! It doesn't help ANYTHING!!!

Katie, give me underweight anytime.  I was naturally underweight and in high school I was 5'5" and weighed 98lbs!!  My father used to tell me that if I stood sideways and stuck out my tongue I'd look like a zipper.........aren't parents wonderful?  LindyLMAO Like a zipper! That's one I have NEVER heard! I know women that are slightly overweight at the onset of a cancer diagnosis tend to fare better than women that are normal weight or underweight.
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