Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders

Area of Science:

• Rheumatology
• Cardiology
• Public Health

Background:

• Inflammatory joint disorders (IJD), including rheumatoid arthritis (RA), ankylosing spondylitis (ASp), and psoriatic arthritis (PsA), are common globally.
• IJD significantly increase the risk of cardiovascular (CV) morbidity and mortality, primarily due to atherosclerotic events.
• The CV risk in RA is comparable to that in type 2 diabetes, with higher prevalence of traditional CV risk factors and chronic inflammation as independent contributors.

Purpose of the Study:

• To review the existing literature on the association between IJD and cardiovascular disease.
• To highlight the increased cardiovascular risk in patients with IJD and the current gaps in management.
• To emphasize the need for integrated cardiovascular risk management alongside rheumatic disease treatment.

Main Methods:

• Literature review of studies examining mortality ratios and cardiovascular risk factors in IJD.
• Analysis of the impact of chronic inflammation and disease activity on cardiovascular health.
• Evaluation of current cardiovascular risk management strategies in the context of IJD.

Main Results:

• Standardized mortality ratios for RA, ASp, and PsA are elevated compared to the general population, mainly due to atherosclerotic events.
• Chronic systemic inflammation in IJD is an independent cardiovascular risk factor.
• Optimal control of IJD disease activity with disease-modifying antirheumatic drugs can decrease excess cardiovascular risk.

Conclusions:

• Cardiovascular risk management is essential but often lacking in the routine care of patients with IJD.
• Healthcare professionals and patients must collaborate to implement timely cardiovascular risk assessment and management.
• Integrating cardiovascular screening and treatment strategies into standard care for IJD is necessary to mitigate excess CV morbidity and mortality.