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Managing Cardiovascular Disease Risk in Rheumatoid Arthritis: Clinical Updates and Three Strategic Approaches
Ann M Chodara1, Aimée Wattiaux2, Christie M Bartels3
1Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
Insights
Rheumatoid arthritis (RA) patients face higher cardiovascular disease (CVD) risks. This review clarifies current CVD risk management strategies for RA, highlighting gaps and opportunities in rheumatology care.
Area of Science:
- Rheumatology
- Cardiology
- Public Health
Background:
- Rheumatoid arthritis (RA) is associated with a well-established increase in cardiovascular disease (CVD) risk.
- Effective management strategies for this elevated CVD risk within rheumatology clinics remain unclear.
Purpose of the Study:
- To critically review recent literature (past 5 years) on CVD risk management in RA.
- To identify current knowledge and existing gaps in managing CVD risk for RA patients.
Main Methods:
- Literature review of guidelines, recommendations, and evidence from the last five years.
- Examination of RA-specific management, individual risk assessment, and population-level targeting of traditional CVD risk factors.
Main Results:
- Recent guidelines and evidence were analyzed, focusing on three management approaches.
- Opportunities exist within rheumatology care to integrate CVD risk reduction strategies, drawing from primary care successes and updated professional society guidelines.
Conclusions:
- Further research is needed for evidence-based strategies to manage and reduce CVD risk in RA, particularly given the high percentage of RA visits in specialty clinics.
- Integrating comprehensive CVD risk management into routine rheumatology care is crucial for improving patient outcomes.
Abstract:
ᅟ: The increase in cardiovascular disease (CVD) risk in rheumatoid arthritis (RA) is well known; however, appropriate management of this elevated risk in rheumatology clinics is less clear.
Purpose Of Review:
By critically reviewing literature published within the past 5 years, we aim to clarify current knowledge and gaps regarding CVD risk management in RA.
Recent Findings:
We examine recent guidelines, recommendations, and evidence and discuss three approaches: (1) RA-specific management including treat-to-target and medication management, (2) assessment of comprehensive individual risk, and (3) targeting traditional CVD risk factors (hypertension, smoking, hyperlipidemia, diabetes, obesity, and physical inactivity) at a population level. Considering that 75% of US RA visits occur in specialty clinics, further research is needed regarding evidence-based strategies to manage and reduce CVD risk in RA. This review highlights clinical updates including US cardiology and international professional society guidelines, successful evidence-based population approaches from primary care, and novel opportunities in rheumatology care to reduce CVD risk in RA.