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Published on: May 16, 2025
Adherence to cardiovascular prevention strategies in patients with rheumatoid arthritis
D F van Breukelen-van der Stoep1, J Zijlmans1, D van Zeben1
1a Department of Rheumatology , Sint Franciscus Gasthuis , Rotterdam , The Netherlands.
Insights
Rheumatoid arthritis patients often underestimate their cardiovascular disease risk. While medication adherence is high, lifestyle changes for cardiovascular prevention show moderate patient engagement.
Area of Science:
- Rheumatology
- Cardiology
- Public Health
Background:
- Patients with rheumatoid arthritis (RA) face elevated cardiovascular disease (CVD) risk.
- Current guidelines emphasize aggressive management of CVD risk factors in RA patients.
Purpose of the Study:
- To assess self-reported adherence to cardiovascular (CV) prevention strategies among RA patients.
- To evaluate RA patients' perception of their CVD risk.
Main Methods:
- A validated questionnaire assessed adherence to CV prevention in RA patients.
- Cardiovascular risk was calculated using the SCORE algorithm.
- Patients received guideline-adherent management and lifestyle advice.
Main Results:
- 53% of RA patients had high 10-year CVD risk (≥20%), yet only 3% perceived their risk as high.
- High adherence (90%) was reported for prescribed lipid- and/or blood pressure-lowering drugs.
- Moderate adherence was observed for lifestyle interventions like diet (68%) and physical exercise (62%).
Conclusions:
- RA patients frequently underestimate their substantial CVD risk.
- Self-reported adherence is high for pharmacotherapy but moderate for lifestyle modifications in CVD risk management.
Objectives:
Patients with rheumatoid arthritis (RA) have a high risk of cardiovascular disease (CVD). Recent national and international guidelines suggest strict treatment of CVD risk factors in RA. The aim of this study was to evaluate the self-reported adherence to CV prevention strategies in patients with RA.
Method:
RA patients visiting an outpatient clinic for strict CVD risk management received a validated questionnaire to evaluate adherence to CV prevention strategies. Strict treatment targets were defined and lifestyle recommendations were given following a prespecified protocol. CVD risk was assessed using the SCORE algorithm.
Results:
In total, 111 questionnaires were returned (response rate of 82%). A high 10-year CVD risk (≥ 20%) was present in 53%, but only 3% thought they had an increased CVD risk. A total of 53% of patients reported that they 'follow the doctors' suggestions exactly' and 75% reported finding it 'easy to follow the suggestions'. Of the 69% of patients who were prescribed lipid- and/or blood pressure-lowering drugs, 90% reported taking all prescribed tablets. The advice to follow a diet was given to 42%, of whom 68% said they followed the advised diet. Physical exercise was advised to 67%, of whom 62% said they performed specific physical exercise on at least 3 days a week. The adherence to lifestyle recommendations was not significantly different across the CVD risk groups.
Conclusions:
RA patients tend to underestimate their CVD risk. The self-reported adherence of RA patients to CVD risk management was high concerning pharmaceutical interventions and moderate in the case of lifestyle interventions.
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