Discrepancies in risk age and relative risk estimations of cardiovascular disease in patients with inflammatory joint
Grunde Wibetoe1, Eirik Ikdahl1, Silvia Rollefstad1
1Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Insights
Patients with inflammatory joint diseases (IJD) have higher cardiovascular disease (CVD) risk. Risk age models identify many IJD patients needing intensive CVD prevention, but models show significant discrepancies.
Area of Science:
- Rheumatology
- Cardiology
- Preventive Medicine
Background:
- European guidelines recommend risk algorithms for cardiovascular disease (CVD) prevention in low-risk individuals.
- Patients with inflammatory joint diseases (IJD) face elevated CVD risk.
- Accurate CVD risk stratification in IJD is crucial for timely intervention.
Purpose of the Study:
- To estimate relative CVD risk and risk age across different IJD entities.
- To evaluate the agreement between 'cardiovascular risk age' and 'vascular age' models in IJD patients.
- To identify IJD patients potentially benefiting from intensified CVD preventive strategies.
Main Methods:
- Utilized cross-sectional data from a nationwide CVD risk assessment project in IJD.
- Calculated risk age using cardiovascular risk age and vascular age models for patients with low/moderate absolute CVD risk.
- Compared risk age estimations via regression analysis and calculated percentage of discrepancies ≥5 years.
Main Results:
- Elevated relative CVD risk was observed in 53% of IJD patients; 20% had ≥3 times higher risk.
- 20-42% of patients exhibited a risk age ≥5 years older than their actual age.
- Discrepancies of ≥5 years between risk age models were found in 14-43% of patients, with a maximum difference of 24 years.
Conclusions:
- Estimating relative CVD risk and risk age can identify additional IJD patients requiring intensive preventive efforts.
- Substantial discrepancies exist between the 'cardiovascular risk age' and 'vascular age' models.
- Further research is needed to reconcile differing risk age model outputs for optimal CVD management in IJD.
Objective:
The European guidelines on cardiovascular disease (CVD) prevention advise use of relative risk and risk age algorithms for estimating CVD risk in patients with low estimated absolute risk. Patients with inflammatory joint diseases (IJD) are associated with increased risk of CVD. We aimed to estimate relative risk and risk age across IJD entities and evaluate the agreement between 'cardiovascular risk age' and 'vascular age models'.
Methods:
Using cross-sectional data from a nationwide project on CVD risk assessment in IJD, risk age estimations were performed in patients with low/moderate absolute risk of fatal CVD. Risk age was calculated according to the cardiovascular risk age and vascular age model, and risk age estimations were compared using regression analysis and calculating percentage of risk age estimations differing ≥5years.
Results:
Relative risk was increased in 53% and 20% had three times or higher risk compared to individuals with optimal CVD risk factor levels. Furthermore, 20-42% had a risk age ≥5years higher than their actual age, according to the specific risk age model. There were only minor differences between IJD entities regarding relative risk and risk age. Discrepancies ≥5years in estimated risk age were observed in 14-43% of patients. The largest observed difference in calculated risk age was 24years.
Conclusion:
In patients with low estimated absolute risk, estimation of relative CVD risk and risk age may identify additional patients at need of intensive CVD preventive efforts. However, there is a substantial discrepancy between the risk age models.
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