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Comparison of cardiovascular risk in ankylosing spondylitis and rheumatoid arthritis

D McCarey1, R D Sturrock

  • 1Centre for Rheumatic Diseases, University of Glasgow, Glasgow, United Kingdom.

Clinical and Experimental Rheumatology
|October 14, 2009
PubMed

Insights

Chronic inflammation increases cardiovascular risk in inflammatory joint diseases like rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Treatments targeting inflammation may reduce these risks.

Area of Science:

  • Rheumatology
  • Immunology
  • Cardiology

Background:

  • Chronic inflammation is linked to cardiovascular complications, including hypertension, stroke, and myocardial infarction.
  • Inflammatory joint diseases like rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with dyslipidemia, elevated C-reactive protein (CRP), and interleukin-6 (IL-6) levels.
  • RA patients exhibit increased mortality, primarily due to cardiovascular disease, while AS patients show a lesser, but still significant, cardiovascular morbidity.

Purpose of the Study:

  • To explore the relationship between chronic inflammation, cardiovascular co-morbidity, and inflammatory joint diseases.
  • To investigate the impact of dyslipidemia and acute phase response markers on cardiovascular risk in RA and AS.
  • To examine the potential of anti-tumour necrosis factor-alpha (TNF-alpha) therapies in mitigating cardiovascular complications.

Main Methods:

  • Review of existing literature on cardiovascular complications in inflammatory joint diseases.
  • Analysis of the association between inflammatory markers (CRP, IL-6) and lipid profiles.
  • Evaluation of studies investigating the effects of anti-TNF-alpha therapy on cardiovascular outcomes.

Main Results:

  • An elevated acute phase response is a predisposing factor for hypertension, stroke, and myocardial infarction.
  • Dyslipidemia is a characteristic feature of inflammatory joint diseases, correlating with elevated CRP and IL-6.
  • Therapeutic agents like anti-TNF-alpha drugs may reduce cardiovascular complications in RA and AS by down-regulating the acute phase response.

Conclusions:

  • Cardiovascular co-morbidity is a significant concern in chronic inflammatory conditions, particularly RA and AS.
  • Management of inflammation and associated dyslipidemia is crucial for reducing cardiovascular risk.
  • Targeting inflammatory pathways with agents like anti-TNF-alpha shows promise in preventing cardiovascular events in these patient populations.

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