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CVD risk may be as important in rheumatoid arthritis as in diabetes
19 August 2008
MedWire News: Patients with rheumatoid arthritis are at as high a risk for cardiovascular disease (CVD) as are Type 2 diabetic patients, report researchers.
They call for more aggressive CVD prevention programs in individuals with rheumatic diseases.
Writing in the Annals of the Rheumatic Diseases, Mike Nurmohamed (VU University Medical Center, Amsterdam, The Netherlands) and associates say that the known increase in CVD risk in patients with rheumatoid arthritis has not been fully quantified, and that this limits the implementation of programs to manage this risk.
In view of this, Nurmohamed and team undertook the Cardiovascular Research and Rheumatoid Arthritis (CARRÉ) study, recruiting 353 outpatients with rheumatoid arthritis aged 50-75 years.
They then compared the prevalence of CVD in this group with that in 194 individuals with Type 2 diabetes and 258 individuals with neither rheumatoid arthritis nor diabetes who took part in a separate study.
Analysis showed that 5.0% of those without diabetes or rheumatoid arthritis had CVD, with the prevalence rising significantly to 12.4% in those with Type 2 diabetes and 12.9% in those with rheumatoid arthritis.
The investigators report that this was equivalent to an adjusted odds ratio for CVD of 2.0 in those with Type 2 diabetes and 2.7 in those with rheumatoid arthritis, compared with those without either condition.
Of note, although the risk for CVD was similar in those with rheumatoid arthritis and diabetes, the pattern of disease was different. Specifically, patients with rheumatoid arthritis were more likely to develop coronary artery disease than those with Type 2 diabetes, who most commonly developed peripheral artery disease.
The investigators point out that their cross-sectional study cannot show causality, and say further controlled prospective studies are necessary.
On the strength of their findings, the team concludes that rheumatoid arthritis should be considered as a high CVD risk condition, potentially equivalent to Type 2 diabetes, and emphasize the need for cardiovascular risk management in these patients.
