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Prevention of cardiovascular disease in patients with rheumatic diseases
Robyn Domsic1, Kathleen Maksimowicz-McKinnon, Susan Manzi
1University of Pittsburgh, Division of Rheumatology and Clinical Immunology, Pittsburgh, PA 15261, USA.
Insights
Cardiovascular disease (CVD) is a major concern for patients with rheumatic diseases, showing increased prevalence and events. Current management involves adapting general population guidelines for these higher-risk individuals.
Area of Science:
- Rheumatology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is the leading cause of death in the USA.
- CVD is a significant comorbidity in rheumatic diseases.
- Improved disease-modifying therapies have highlighted increased CVD prevalence in rheumatic patients.
Purpose of the Study:
- To investigate the increased prevalence and incidence of cardiovascular (CV) events in rheumatic disease patients.
- To explore potential mechanisms and etiologies for heightened CV risk in this population.
- To inform screening and intervention strategies for CV risk in rheumatic disease.
Main Methods:
- Comparative analysis of CVD prevalence and events in rheumatic disease patients versus the general population.
- Review of existing research on CVD mechanisms in the general population for insights into rheumatic disease.
- Evaluation of current best practices for CV risk factor screening and intervention.
Main Results:
- Rheumatic disease patients exhibit a significantly increased prevalence of CVD and CV events compared to age- and gender-matched controls.
- Mechanisms of CVD in the general population offer potential explanations for increased risk in rheumatic diseases.
- No specific evidence-based guidelines currently exist for CV risk management tailored to rheumatic disease patients.
Conclusions:
- Patients with rheumatic diseases face a substantially elevated risk of cardiovascular disease and events.
- Management strategies should adapt general population CV guidelines, considering the specific risk profiles of rheumatic disease patients.
- Further research is needed to develop tailored CV risk factor screening and intervention protocols for this vulnerable group.
Abstract:
Cardiovascular disease (CVD), the leading cause of death in the USA, has emerged as an important comorbidity in the rheumatic diseases. As disease-modifying therapies have resulted in better disease control and decreases in disease-associated mortality, it is now apparent that the prevalence of CVD and cardiovascular (CV) events is significantly increased in a number of rheumatic disorders when compared with age and gender-matched subjects from the general population. Investigations into the mechanisms of CVD in the general population have provided insights into potential mechanisms in rheumatic disease patients and possible aetiologies for their increased risk. Although there are no evidence-based guidelines for CV risk factor screening and interventions specific to patients with rheumatic disease, the best current approach utilizes evidence-based recommendations for the general population (and higher-risk subgroups) modified by what is known of CV risk factor and event prevalence in these patients.
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