Nearly One-Third of CVD Risk Attributable to RA Characteristics in Patients With RA

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Patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease, making it important to assess the risk factors that influence RA so physicians can better treat high-risk patients.

A new study published in Annals of Rheumatic Diseases from researchers around the world aimed to better understand the impact of risk factors for cardiovascular disease in patients with RA. They collected data on cardiovascular disease risk factors and RA characteristics for 5638 patients with RA and no previous cardiovascular disease from 13 rheumatology centers in 10 different countries. They studied outcomes for myocardial infarction, angina, revascularization, stroke, peripheral vascular disease, and cardiovascular death.

The researchers looked at both traditional cardiovascular risk factors, such as age, sex smoking status, blood pressure, lipid levels, and family history of cardiovascular disease, as well as RA-specific factors, such as rheumatoid factor, C reactive protein, and Disease Activity Score.

The data showed that after follow-up there was a 10-year cumulative incidence rate of having a cardiovascular event of 20.9% for men and 11.1% for women. Men had a higher burden of cardiovascular disease risk factors compared with women.

The researchers found that smoking, hypertension, and cholesterol were the strongest predictors of cardiovascular disease among the traditional cardiovascular risk factors. Cardiovascular disease risk factors explain 49% of cardiovascular risk, while 30.3% of cardiovascular disease risk was attributable to RA characteristics. The remaining 30.4% of cardiovascular risk was unaccounted for.

There were differences by sex. Cardiovascular risk factors had a higher population attributable risk among men, while RA characteristics had a higher attributable risk among women.

According to the authors, the study’s results indicate that “RA characteristics play an important role in efforts to reduce [cardiovascular disease] risk among patients with RA.”