Cardiovascular disease (CVD) prevention in rheumatoid arthritis (RA) patients depends on personal risk reduction strategies, believe researchers who have identified the factors that mediate the relationship between the two conditions.
Individuals with RA are around three-times more likely to die from CVD than those without auto-immune conditions. They are also often reluctant to report symptoms of CVD and, therefore, more likely to die from sudden cardiac death.
Identifying RA patients at risk for CVD requires a thorough understanding of the factors that modulate this risk, reason Sherine Gabriel (Mayo Foundation, Rochester, Minnesota, USA) and co-workers in the journal Arthritis and Rheumatism.
To this end, Gabriel et al compared the incidence of, and factors predicting CVD in 553 patients with RA and 574 generally healthy, age- and sex-matched volunteers.
The researchers confirmed the profound influence of risk factors on CVD risk in RA patients.
Ten-year CVD risk among 60-69-year-old patients with no risk factors was 16.8%, compared with 60.4% in those who smoked, were obese, and had hypertension, dyslipidemia, and diabetes, the team reports in the journal Arthritis and Rheumatism.
Age was the most important determinant of increased CVD risk in those with RA and, overall, those with RA had a similar risk for CVD as those without RA who were 5-10 years older.
The authors acknowledge that their findings may not be applicable to the general population since the majority of those involved in the study were Caucasian.
Still, they say the results "underscore the importance of careful cardiovascular risk assessment for each newly diagnosed RA patient, followed by individualized preventive care."
The investigators recommend that future research "should focus on the development of RA-specific CVD risk scores designed to more accurately identify RA patients' unique risk profiles and guide individualized therapy."