NEW YORK (Reuters Health) - Compared to the general population, patients with rheumatoid arthritis (RA) have about twice the risk of cardiovascular disease, Dutch researchers report in the November 15th issue of Arthritis and Rheumatism.
"Patients with RA have an increased cardiovascular risk with a magnitude that is at least comparable to type II diabetes," senior investigator Dr. Michael T. Nurmohamed, of VU Medical Center, Amsterdam, told Reuters Health.
Dr. Nurmohamed and colleagues compared two groups: 353 outpatients with RA, and 1,852 participants in a population-based cohort study, of whom 155 had diabetes mellitus.
The 3-year incidence of cardiovascular disease was 9.0% in patients with RA and 4.3% in the general population, corresponding to incidence rates per 100 patient-years of 3.30 and 1.51, respectively. Exclusion of patients with prior cardiovascular disease and adjustment for risk factors did not significantly alter this finding.
Compared with the non-diabetic general population, RA patients without diabetes had a hazard ratio for cardiovascular disease of 2.16, and patients with type II diabetes had a hazard ratio of 2.04.
Given these findings, continued Dr. Nurmohamed, "cardiovascular risk management is mandatory."
"This should target traditional cardiovascular risk factors as well as disease activity" as defined in The European League Against Rheumatism guidelines, he concluded.
Arthritis Rheum 2009;61:1571-1579.