Cardiovascular Risk Factors in Chronic Inflammatory Rheumatic Diseases: Modern Assessment and Diagnosis

Area of Science:

• Rheumatology
• Cardiology
• Immunology

Background:

• Systemic inflammation in chronic inflammatory rheumatic diseases (CIRD) is linked to accelerated atherosclerosis.
• CIRD patients exhibit high rates of cardiovascular (CV) morbidity, mortality, and atherosclerosis.
• Traditional CV risk factor assessment often underestimates risk in CIRD patients.

Purpose of the Study:

• To highlight the need for comprehensive CV risk evaluation in CIRD.
• To identify traditional and non-traditional CV risk factors and markers relevant to CIRD.
• To emphasize early diagnosis and integrated management strategies for CV complications in CIRD.

Main Methods:

• Review of current understanding of atherosclerosis in CIRD.
• Identification of diagnostic imaging techniques (e.g., carotid intima-media thickness, flow-mediated vasodilation) for endothelial dysfunction.
• Analysis of immunologic and metabolic markers (e.g., anti-CCP antibodies, cytokines, homocysteine) implicated in CIRD-specific atherosclerosis.

Main Results:

• Traditional CV risk factors are insufficient for accurate risk assessment in CIRD.
• Endothelial dysfunction and atherosclerosis are prevalent and accelerated in CIRD.
• Specific immunologic and metabolic markers may play a role in CIRD-related atherogenesis.

Conclusions:

• A comprehensive approach to CV risk assessment, including non-traditional factors and early endothelial dysfunction diagnosis, is essential for CIRD patients.
• Integrated management strategies involving CIRD treatment, atherosclerosis control, lifestyle changes, and regular follow-ups are necessary.
• Aggressive prevention and therapy targeting inflammation and immune/metabolic disorders are key to managing CV risk in CIRD.