Cardiovascular Risk Reduction for RA | Arthritis Information

EULAR Issues Guidance on CVD Risk Reduction: RA, AS, and PsA are as lethal as diabetes.

EULAR's Management Recommendations 

The EULAR task force issued the following recommendations:

▸ Patients with RA, AS, or PsA should be considered at high risk for developing CVD.

▸ Adequate control of rheumatoid disease activity is necessary to lower CVD risk.

▸ An annual CVD risk assessment following EULAR guidelines is recommended for all RA patients; should be considered for all patients with AS and PsA; and should be repeated if antirheumatic treatment changes. The assessment should be initiated by the patient's rheumatologist, and may be done by the rheumatologist, a cardiologist, or a primary care physician with an interest in CVD.

▸ CVD risk score models should be multiplied by 1.5 when an RA patient has disease duration longer than 10 years; positivity for rheumatoid factor or anti-cyclic citrullinated peptide antibody; or extra-articular manifestations.

▸ The total cholesterol: HDL cholesterol ratio should be used in the formula for estimating CVD risk.

▸ Interventions with lipid-lowering drugs and antihypertensive medications should follow national guidelines.

▸ Statins, ACE inhibitors, and angiotensin receptor blockers are the preferred treatment agents because of their pleiotropic effects.

▸ Cyclooxygenase-2 selective inhibitors (coxibs) and most NSAIDs should be prescribed with caution.

▸ If prescribed, cortico-steroids should be at the lowest dose possible.

http://www.rheumatologynews.com/article/S1541-9800(09)70178-4/fulltext

Interesting, but very scary.  I wonder what they consider "adequate control" of RA?

Phats