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Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis

Daniel H Solomon1, Elizabeth W Karlson, Eric B Rimm

  • 1Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA. dhsolomon@partners.org

Circulation
|March 12, 2003
PubMed

Insights

Women with rheumatoid arthritis face a doubled risk of myocardial infarction. Long-term rheumatoid arthritis (RA) increases heart attack risk significantly, underscoring the need for cardiovascular disease prevention in RA patients.

Area of Science:

  • Rheumatology
  • Cardiology
  • Epidemiology

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory condition.
  • RA is potentially linked to an elevated risk of cardiovascular disease (CVD).

Purpose of the Study:

  • To compare the incidence of myocardial infarction (MI) and stroke in women with and without RA.
  • To investigate the association between RA duration and MI risk.

Main Methods:

  • Prospective cohort study of 114,342 women from the Nurses' Health Study (1976-2000).
  • Exclusion of participants with pre-existing CVD or RA at baseline.
  • Confirmation of RA, MI, and stroke cases through medical record review.
  • Multivariate logistic regression adjusted for CVD risk factors.

Main Results:

  • An increased risk of MI was observed in women with RA (adjusted RR=2.0, 95% CI: 1.23-3.29).
  • The risk of stroke was not significantly increased in women with RA (adjusted RR=1.48, 95% CI: 0.70-3.12).
  • Women with RA for ≥10 years had a substantially higher MI risk (adjusted RR=3.10, 95% CI: 1.64-5.87).

Conclusions:

  • RA is associated with a significantly higher risk of MI, but not stroke.
  • Findings suggest a need for enhanced coronary heart disease prevention strategies in individuals with RA.
  • Further research is warranted to confirm these associations and guide clinical practice.
Abstract

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