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Suboptimal cardiovascular risk factor identification and management in patients with rheumatoid arthritis: a cohort

Shailey S Desai, James D Myles, Mariana J Kaplan

    Arthritis Research & Therapy
    |December 15, 2012
    PubMed

    Insights

    Primary care physicians manage cardiovascular risk factors more often than rheumatologists in rheumatoid arthritis patients. However, PCPs manage these factors less frequently in RA patients compared to those with diabetes or the general population.

    Area of Science:

    • Cardiology
    • Rheumatology
    • Primary Care Medicine

    Background:

    • Rheumatoid arthritis (RA) patients face accelerated cardiovascular (CV) disease, leading to increased mortality comparable to type 2 diabetes mellitus (DM).
    • Traditional cardiovascular risk factors (CRFs) contribute to this enhanced CV risk in RA.
    • Understanding CRF identification and management patterns is crucial for improving outcomes.

    Purpose of the Study:

    • To compare the identification and management of CRFs by rheumatologists versus primary care physicians (PCPs) in RA patients.
    • To compare CRF management by PCPs across RA, DM, and general population (GP) cohorts.

    Main Methods:

    • Retrospective cohort study design.
    • Comparison of age/gender/ethnicity-matched patients (n=251 per group) across RA, DM, and GP cohorts.
    • Review of electronic patient records over a 12-month period (June 2007-April 2011) to assess CRF identification and management.

    Main Results:

    • PCPs managed obesity, blood pressure (BP), and lipids significantly more often than rheumatologists in RA patients.
    • PCPs demonstrated higher management rates for obesity, BP, and lipids in DM patients compared to RA and GP groups.
    • Weight management for elevated BMI was highest in DM (68%), followed by GP (46%), and lowest in RA (31%) patients.

    Conclusions:

    • Rheumatologists identify and manage CRFs less frequently than PCPs.
    • PCPs manage CRFs less frequently in RA patients compared to DM and GP cohorts.
    • Aggressive management of CRFs is essential for RA patients due to their elevated CV risk.
    Abstract

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