Vascular function and morphology in rheumatoid arthritis: a systematic review
Aamer Sandoo1, Jet J C S Veldhuijzen van Zanten, George S Metsios
1Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Pensnett Road, Dudley, West Midlands DY1 2HQ, UK. aamer.sandoo@dgh.nhs.uk
Rheumatology (Oxford, England)
|September 20, 2011
Summary
Rheumatoid arthritis (RA) patients show impaired vascular function and morphology. While anti-inflammatory treatments offer improvements, the direct link between systemic inflammation and vascular changes in RA requires further long-term investigation.
Area of Science:
- Rheumatology
- Cardiovascular Medicine
- Vascular Biology
Background:
- Rheumatoid arthritis (RA) is linked to increased cardiovascular disease (CVD) risk.
- Complex interactions between RA, traditional CVD risk factors, and vascular health are implicated.
- Understanding vascular alterations in RA is crucial for patient outcomes.
Purpose of the Study:
- To assess evidence for altered vascular function and morphology in RA patients compared to controls.
- To determine if vascular changes in RA are primarily driven by systemic inflammation.
- To investigate if therapies can modify vascular function and morphology in RA.
Main Methods:
- Systematic literature review of publications from 1974 to November 2010.
- Searched MEDLINE database for studies on vascular function and morphology in RA.
- Included 93 articles: 57 cross-sectional, 27 non-randomized longitudinal, 9 randomized longitudinal studies.
Main Results:
- Vascular function and morphology were impaired in RA patients relative to healthy individuals.
- Most studies found no significant association between systemic inflammation and vascular function.
- Anti-inflammatory medication improved vasculature transiently and long-term, but links to inflammation changes were few.
Conclusions:
- The direct relationship between systemic inflammation and vascular changes in RA is not strongly supported by current literature.
- Further long-term research is needed to identify specific predictors of vascular health in RA, including traditional CVD risk factors.
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