[Cardiovascular comorbidities in rheumatoid arthritis] | JoVE Visualize

Area of Science:

Rheumatology
Cardiology
Internal Medicine

Background:

Rheumatoid arthritis (RA) patients have a significantly higher prevalence of cardiovascular (CV) diseases, with over 50% affected.
Inflammatory activity in RA is a primary driver of atherosclerosis, coronary heart disease, stroke, thromboembolic events, and heart failure, leading to a doubled CV event rate and increased mortality in RA patients.
Traditional CV risk factors like hypertension, diabetes, and hyperlipidemia are more common in RA patients and often go undetected or untreated, contributing to overall CV risk.

Purpose of the Study:

To highlight the connection between RA inflammatory activity and increased cardiovascular risk.
To emphasize the importance of managing traditional cardiovascular risk factors in RA patients.
To discuss the impact of RA medications on cardiovascular risk and propose strategies for risk assessment and management.

Main Methods:

Review of existing literature on RA, comorbidities, and cardiovascular disease.
Analysis of the role of inflammatory activity and traditional risk factors in RA-associated CV events.
Evaluation of the cardiovascular risk profiles of different RA treatment modalities.
Discussion of current gaps in CV risk assessment and management in RA care.

Main Results:

Inflammatory activity in RA is a major contributor to cardiovascular disease, which affects RA patients twice as frequently as the general population.
While some RA medications (NSAIDs, glucocorticoids) increase CV risk with long-term use, others (hydroxychloroquine, methotrexate, biologics) can reduce it.
Untreated traditional CV risk factors are prevalent in RA patients, and addressing them can improve life expectancy.

Conclusions:

Cardiovascular risk is substantially elevated in rheumatoid arthritis patients, primarily due to inflammatory activity and often compounded by traditional risk factors.
Rheumatologists should be responsible for assessing and managing CV risk factors in RA patients, as current practices often fall short.
Standardized, nursing-based assessments and regular risk reassessment (every 1-5 years) are recommended to mitigate CV risks and improve outcomes in RA patients.