Cardiovascular risk assessment and treatment in chronic inflammatory disorders in primary care

Area of Science:

• Rheumatology
• Gastroenterology
• Cardiology
• Primary Care Medicine

Background:

• Rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) are associated with increased cardiovascular disease (CVD) risk.
• Effective management of CVD risk factors is crucial for these patient populations.
• Primary care plays a vital role in assessing and managing vascular risk.

Purpose of the Study:

• To compare the assessment and management of cardiovascular (CV) risk factors in patients with RA and IBD against matched controls.
• To evaluate trends in CV risk factor assessment and treatment over time relative to diagnosis.
• To identify gaps in vascular risk management within primary care for RA and IBD patients.

Main Methods:

• A matched cohort study utilizing primary care electronic health records.
• Identification of RA, IBD patients, and matched controls from London general practices.
• Comparison of CV risk factor assessment (blood pressure, BMI, cholesterol, smoking) and treatment in the years before, after, and 5 years post-diagnosis.

Main Results:

• Patients with RA and IBD showed higher rates of CV risk factor measurement compared to controls, though this difference diminished over 5 years.
• RA patients had higher antihypertensive prescription rates, while IBD patients had higher statin prescription rates pre-diagnosis.
• Incomplete CV risk assessment was prevalent, with QRISK scores calculable for only 17% of RA patients and 11% of IBD patients.

Conclusions:

• Vascular risk assessment and management in primary care for RA and IBD patients are suboptimal.
• There is a significant need for improved calculation and recording of CVD risk scores in these patient groups.
• Enhanced primary care strategies are required to optimize cardiovascular risk management for individuals with RA and IBD.