Rheumatoid Arthritis and Your Heart | Arthritis Information

 

The inflammation that damages joints also takes a toll on the heart. Johns Hopkins doctors offer bottom line advice.

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.

http://www.johnshopkinshealthalerts.com/alerts/arthritis/JohnsHopkinsArthritisHealthAlert_1515-1.html Lynn492010-02-17 05:26:29

Lynne,

Thank you for the info. I think it is an important reminder. It is true we suffer and deal with joint pain and sort of put it front row, but it is equally important to be reminded to take care of our overall health,.

For me losing a bit of weight and staying active and watching my diet is something I need to stay on top of. I want a strong heart and a long life.

well this article just scared the daylights out of me...LOL.. BUT, it's good to know these things as well so thanks for posting .Scared me too... This may be scary, but it is so very important to know!  My grandmother died this way, she had RA too.  RA is thought to have contributed to the early demise of my heart valve as well.  I also have a moderate amount of plaque; not what I or my CD expected. 

I am trying to control what I can through lifestyle, but the amount of inflammation I have still worries me.  I now take an aspirin a day and my CD said we would look at adding a statin in March at my next check up. 

Thank-you so much Lynn.  It maybe worrisome, but, gosh, its so very, very important!

This is scary for me too because heart attack and stroke run in my family and I have had very high trigyceride readings on several occasions. They are normally at near 300 which is double what they should be. Also I always wondered if my high CRP readings were RA related or heart related???? My doctor said That's a good question wannabe!

There's an obvious link between inflammation and heart problems, it seems.  If one can control the inflammation with RA drugs, as we're all trying to do, that's helpful.  I wonder though how much damage the drugs themselves do to our hearts as well.  Not to throw gasoline on the fire!

TTT Everyone with RA should pay attention to this! [QUOTE=SnowOwl]My husband can't tolerate statin drugs, or fenofibrates.  I suggested he ask his GP about Lovaza, prescription strength omega-3 that has supposedly been quite successful in clinical trial at significantly lowering triglyceride levels.  It's my understanding omega-3 is also an anti-inflammatory.  I added an omega-3 fish oil capsule to my daily meds regimen a while back, and while it may be unrelated my shoulder joint pain has eased noticeably.  He also takes Niaspan which is a prescription strength niacin, and his "bad" cholesterol has been reduced by almost half to a quite acceptable number and his "good" cholesterol has increased (still on the low side, but way better than it was, we're working on that).[/QUOTE]

My CD is thinking of starting me on statins.  I already take high dose omega 3's and I wonder if this is as good as Lovaza?  I am going to ask him about this and the prescription niacin on my next visit.  Taking prescription strength omega 3's would be cheaper for me than buying over the counter!

Thanks Snow! Thank you for this info.  I didn't realize how much RA impacts these other issues.  My mother had RA for many, many years - later in life she had numerous heart attacks and finally a stroke that ended her life.  My father also died after having a stroke. Waddie- my doctor wants me on Lovaza due to the 2 triglyceride readings over 900 in 2 years. Both times 2nd reading came down to the high 200's 2nd test.
She swears that this prescription fish oil cannot be touch by over the counter. She says it's 100 times more potent.
 I went on the website and it seemed geared towards people with readings of 500 and above.
On WebMd a lot of people rated the drug. Most people had GI problems on it....but then again people usually only write when they are having problems...
I agree that it is much stronger than over the counter fishoil. I had a problem with it. It made me sleep and my bloodsugar got very low probably why I was so sleepy. So I switched to over the counter fishoil and did much better. I think it worked great for inflamation. Just it says it can regulate your thyroid and your bloodsugar and it can.
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