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Cardiovascular risk factors, including thrombotic variables, in a population with rheumatoid arthritis
A McEntegart1, H A Capell, D Creran
1Centre for Rheumatic Diseases, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
Insights
Rheumatoid arthritis (RA) patients exhibit higher cardiovascular disease risk, with elevated diastolic blood pressure and thrombotic factors like fibrinogen and von Willebrand factor (vWF). These findings highlight potential additional risks in RA management.
Area of Science:
- Rheumatology
- Cardiovascular Medicine
- Hematology
Background:
- Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) risk.
- Understanding specific risk factors in RA is crucial for effective management.
Purpose of the Study:
- To compare CVD prevalence, cardiovascular risk factors, and thrombotic variables in RA patients versus population controls.
- To identify potential additional CVD risk factors in well-controlled RA.
Main Methods:
- A cohort study comparing 76 RA patients with 641 population controls.
- Measurement of conventional CVD risk factors (blood pressure, cholesterol, smoking) and thrombotic variables (fibrinogen, vWF, t-PA, D-dimer, PAI-1, plasma viscosity).
Main Results:
- RA patients showed a higher prevalence of angina pectoris (P=0.03).
- Elevated diastolic blood pressure and lower serum cholesterol were observed in RA patients.
- Significantly higher levels of thrombotic predictors, including fibrinogen, vWF, t-PA antigen, and fibrin D-dimer, were found in the RA group.
Conclusions:
- Well-controlled RA patients present with higher diastolic blood pressure and elevated thrombotic variables compared to controls.
- These factors represent potential additional cardiovascular risks in RA.
- Further prospective studies are needed to identify risk modification strategies to reduce CVD risk in RA.
Objective:
To compare prevalent cardiovascular disease, conventional cardiovascular risk factors and thrombotic variables in a cohort with well-controlled rheumatoid arthritis (RA) and in population controls.
Methods:
Seventy-six RA patients and 641 controls, randomly sampled from the local population in the North Glasgow MONICA study. Conventional cardiovascular risk factors (blood pressure, smoking, cholesterol) and thrombotic variables [fibrinogen, von Willebrand factor (vWF), tissue plasminogen activator antigen (t-PA), fibrin D-dimer, plasminogen activator inhibitor (PAI-1), plasma viscosity] were measured by standard procedures.
Results:
RA patients had a significantly higher prevalence of angina pectoris (P=0.03). Stroke also tended to be more common in the RA group, but the difference did not reach statistical significance (P=0.08). Diastolic blood pressure was significantly higher and serum cholesterol significantly lower in the RA group than in controls. Current smoking habits and exercise history were similar in the two groups, although RA patients were more likely to have previously smoked. Significant elevations in several thrombotic predictors of cardiovascular disease (fibrinogen, vWF, t-PA antigen and fibrin D-dimer) were found in the RA group.
Conclusions:
In this RA patient population, diastolic blood pressure was higher than in controls and thrombotic variables were elevated compared with controls. These features are identified as potential additional cardiovascular risk factors in the RA patients studied. Prospective studies of risk modification may permit the identification of factors which could lead to a reduction in the known increased cardiovascular risk in RA.