Acceleration of atherosclerosis in RA | Arthritis Information

Division of Clinical Immunology, Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, United States.

Patients with rheumatoid arthritis (RA) are predisposed to atherosclerosis and cardiovascular disease. This is thought to be caused in part, by exposure to chronic systemic inflammation during the course of the disease. We hypothesized that RA disease duration augments the effect of age on atherosclerosis. We measured the carotid artery intima-media thickness (IMT) in 631 consecutive RA patients. We ascertained age, sex and disease duration, established CV risk factors, RA clinical manifestations and markers of inflammation. We used multivariable regression to model IMT, with age as the independent variable. We then added RA duration quartile x age interaction terms to estimate the IMT-age relationship within RA duration strata. We found that the rate at which the IMT increased per unit of age steepened in proportion to the RA duration, from 0.154 mm/10 years among patients with RA for 7 years or less, to 0.295 mm/10 years among patients with RA for 20 years or more (P<or=0.001). None of the covariates effaced the significance of the age x RA duration product terms. Thus, patients with prolonged RA have more atherosclerosis than patients of the same age with more recent disease onset. This suggests that atherogenesis accelerates after the onset of RA. Systemic inflammation may amplify the age-related risk of CV disease.

Published 20 November 2007 in Atherosclerosis, 195(2): 354-60.
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Hey Lynn, these articles on the heart really interest me. In reference to yesterday's article "New thinking on how to protect the heart" and today's, what is the answer? Atherosclerosis was noted by the radiologist on my last CT, so this is getting scary. I know I need to talk to the doctor and I will when I have my appointment at the end of the month. But it seems that exercise, diet and weight control, while great for you is not enough if you have RA, or any chronic inflammatory disease for that mater. Is atherosclerosis symptom free to the patient? I was shocked to hear my chest CT showed this... I have lost weight, lowered my cholesterol and changed my diet and it has been this way for 3 years now. My last cardiology visit was great. What else should I do? [QUOTE=waddie]Hey Lynn, these articles on the heart really interest me. In reference to yesterday's article "New thinking on how to protect the heart" and today's, what is the answer? Atherosclerosis was noted by the radiologist on my last CT, so this is getting scary. I know I need to talk to the doctor and I will when I have my appointment at the end of the month. But it seems that exercise, diet and weight control, while great for you is not enough if you have RA, or any chronic inflammatory disease for that mater. Is atherosclerosis symptom free to the patient? I was shocked to hear my chest CT showed this... I have lost weight, lowered my cholesterol and changed my diet and it has been this way for 3 years now. My last cardiology visit was great. What else should I do? [/QUOTE]

I wish I had the right answers for you

I know that early atherosclerosis can create a whooshing sound over an artery and that aspirin can help with reducing the risk. I don't really know what else to tell you. It sounds like you are doing all the right things...............

Edited to add...It's really important to get the inflammation caused by RA under control

Lynn492009-01-17 16:56:24Yeah, getting the inflammation under control seems to be the problem...

Cardiac complications of RA is my primary worry now. Diagnosed with a complication last year and to date asymptomatic but who knows when it will rear it's ugly head. The best medicine for this is to achieve clinical remission. That alone will stop the inflammation and possibly slow any cardiac complications. It isn't fair that you spend years trying to get RA under control and it has the audacity to cause cardiac and pulmonary complications that will kill you. Once again I think that everyone with a diagnosis of RA should have a cardiac workup, baseline studies done, and yearly follow-ups. Lindy

crap.

It isn't enough to feel like crap.. you have to worry what will be coming down the road...

looking at my dad's medical history.... I can see it .... :(

During my last visit to the cardiologist, he recommended that I have a calcium scan.

Most insurances do not pay for this and its about 0, but he said it would be well worth it to see how much arterial calcification I have, since my RA is highly active and thus, highly inflammatory.

I'm going submit another post in a bit here, relative to recent labs and results of my trial of MTX and I'll follow up on this subject there.