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Cardiovascular risk in patients with rheumatoid arthritis: assessment of several traditional risk parameters and a
1Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, 30167 Hannover, Germany. willers@nutrition.uni-hannover.de
Insights
Rheumatoid arthritis (RA) patients exhibit a proatherogenic cardiovascular risk profile. Standard risk scores may underestimate the true cardiovascular risk in RA, highlighting the need for adequate monitoring and prevention strategies.
Area of Science:
- Cardiology
- Rheumatology
- Public Health
Background:
- Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) morbidity and mortality.
- Patients with RA often present with a proatherogenic risk profile, necessitating comprehensive CV risk assessment.
Purpose of the Study:
- To evaluate the cardiovascular risk profile in patients with rheumatoid arthritis.
- To assess traditional CV risk factors and calculate CV risk scores in an RA cohort.
- To determine the prevalence of high CV risk in RA patients and compare it with general population risk scores.
Main Methods:
- Cross-sectional data from 100 RA patients were analyzed.
- Traditional CV risk parameters including lipid profile and homocysteine levels were measured.
- CV risk was calculated using risk score calculations for the German population, with an adjustment factor applied.
Main Results:
- A proatherogenic lipid profile was observed in 85% (total cholesterol) and 66% (LDL cholesterol) of patients.
- Elevated homocysteine levels (≥ 10 μmol/l) were found in 67% of the study population.
- High CV risk prevalence was 12%, increasing to 42% with a multiplication factor of 1.5, suggesting potential underestimation by standard scores.
Conclusions:
- RA patients exhibit a proatherogenic risk profile concerning evaluated CV risk factors.
- Standard 10-year CV risk calculations may underestimate the actual risk in RA patients.
- Cardiovascular co-morbidity in RA requires adequate monitoring and should be a primary prevention and treatment target.
Abstract:
The present cross-sectional data demonstrate cardiovascular (CV) risk in patients with rheumatoid arthritis (RA). The cross-sectional data were part of an interventional trial that included 100 patients with defined RA. Traditional CV risk parameters and risk score calculation for the German population were used to assess the CV risk profile in the collective given. Proatherogenic lipid profile characterised by increased total cholesterol (≥ 5.2 mmol/l) and LDL cholesterol (≥ 3.5 mmol/l) levels was measured in 85 and 66%, respectively, of the study population. Elevated concentrations of homocysteine (≥ 10 μmol/l) were reached by 67%. The prevalence of patients at high CV risk was 12% and increased up to 42% after using a multiplication factor of 1.5. No association was seen between the CV risk SCORE and DAS 28 or disease duration. RA patients in this study showed a proatherogenic risk profile with regard to the CV risk factors evaluated. The calculation of a 10-year risk using German risk charts might have led to an overall underestimation of the mean CV risk. Cardiovascular co-morbidity in RA patients must be seen as a major prevention and treatment target and should be monitored adequately.
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