Cardiovascular disease risk profiles in inflammatory joint disease entities
Grunde Wibetoe1,2, Eirik Ikdahl3, Silvia Rollefstad3
1Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vinderen, N-0319, Oslo, Norway. g-wibeto@diakonsyk.no.
Insights
Patients with inflammatory joint diseases (IJD) face a higher cardiovascular disease (CVD) risk. While absolute risk appears low, relative CVD risk is significantly elevated, necessitating proactive risk assessment for all IJD patients.
Area of Science:
- Rheumatology
- Cardiology
- Public Health
Background:
- Patients with inflammatory joint diseases (IJD) exhibit an elevated risk of cardiovascular disease (CVD).
- This study focuses on rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA) within the IJD spectrum.
Purpose of the Study:
- To compare cardiovascular disease (CVD) risk profiles across RA, axSpA, and PsA patients.
- To evaluate the future risk of CVD in individuals diagnosed with these inflammatory joint diseases.
Main Methods:
- Prevalence and number of major CVD risk factors (hypertension, hypercholesterolemia, obesity, smoking, diabetes) were assessed.
- Relative and absolute CVD risk were calculated using the Systematic Coronary Risk Evaluation (SCORE) model.
- Data from 3791 patients were analyzed.
Main Results:
- Hypertension (49.8%) and elevated cholesterol (32.8%) were the most common CVD risk factors among patients without established CVD.
- Over 73% of patients had at least one CVD risk factor, increasing with age.
- While absolute CVD risk was generally low, relative risk was markedly high, with 24.7% having at least three times the risk of individuals without CVD risk factors.
Conclusions:
- Cardiovascular disease risk factors are comparably prevalent across RA, axSpA, and PsA.
- Despite low absolute CVD risk scores, patients with IJD face a significantly higher relative risk of CVD.
- Routine CVD risk assessment is crucial for all patients diagnosed with inflammatory joint diseases.
Background:
Patients with inflammatory joint diseases (IJD) have increased risk of cardiovascular disease (CVD). Our aim was to compare CVD risk profiles in patients with IJD, including rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) and evaluate the future risk of CVD.
Methods:
The prevalence and numbers of major CVD risk factors (CVD-RFs) (hypertension, elevated cholesterol, obesity, smoking, and diabetes mellitus) were estimated in patients with RA, axSpA and PsA. Relative and absolute risk of CVD according to Systematic Coronary Risk Evaluation (SCORE) was calculated.
Results:
In total, 3791 patients were included. CVD was present in 274 patients (7.2%). Of those without established CVD; hypertension and elevated cholesterol were the most frequent CVD-RFs, occurring in 49.8% and 32.8% of patients. Patients with PsA were more often hypertensive and obese. Overall, 73.6% of patients had a minimum of one CVD-RF, which increased from 53.2% among patients aged 30 to <45 years, to 86.2% of patients aged 60 to ≤80 years. Most patients (93.5%) had low/moderate estimated risk of CVD according to SCORE. According to relative risk estimations, 35.2% and 24.7% of patients had two or three times risk or higher, respectively, compared to individuals with no CVD-RFs.
Conclusions:
In this nationwide Norwegian project, we have shown for the first time that prevalence and numbers of CVD-RFs were relatively comparable across the three major IJD entities. Furthermore, estimated absolute CVD risk was low, but the relative risk of CVD was markedly high in patients with IJD. Our findings indicate the need for CVD risk assessment in all patients with IJD.
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