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[Atherosclerosis and rheumatoid arthritis].
1Service de rhumatologie, hôpital G.-Montpied, place H.-Dunant, Clermont-Ferrand, France. msoubrier@chu-clermontferrand.fr
La Revue De Medecine Interne
|July 26, 2005
Summary
Rheumatoid arthritis (RA) significantly increases cardiovascular risk, independent of traditional factors. Managing RA activity and other risk factors can reduce cardiovascular events in patients.
Area of Science:
- Rheumatology
- Cardiology
- Immunology
Context:
- Rheumatoid arthritis (RA) is a chronic inflammatory disease.
- RA is associated with increased cardiovascular morbidity and mortality.
- Traditional cardiovascular risk factors do not fully explain this increased risk.
Purpose:
- To review studies on RA and cardiovascular disease (CVD).
- To identify factors contributing to CVD in RA.
- To explore management strategies to reduce CVD risk in RA patients.
Summary:
- RA patients face a twofold higher risk of cardiovascular events, even without traditional risk factors.
- Endothelial dysfunction, reduced arterial compliance, and increased intima-media thickness are observed in RA.
- Inflammation, dyslipidemia, insulin resistance, and certain RA treatments (corticosteroids, NSAIDs, MTX) contribute to CVD risk.
Impact:
- Strict control of RA disease activity is crucial for reducing cardiovascular morbidity and mortality.
- Managing traditional CVD risk factors (smoking, lipids) is essential.
- Optimizing RA pharmacotherapy, including folic acid supplementation with methotrexate and judicious use of corticosteroids and NSAIDs, can mitigate CVD risk.