Cardiovascular risk management in rheumatoid and psoriatic arthritis: online survey results from a national cohort study
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Premarani Sinnathurai1,2,3, Alexandra Capon2, Rachelle Buchbinder4,5
11Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Sydney, NSW Australia.
Insights
Most rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients use medication for cardiovascular risks. However, few adopt lifestyle changes, indicating a need for targeted interventions in these inflammatory arthritis populations.
Area of Science:
- Rheumatology
- Cardiovascular Health
- Public Health
Background:
- Chronic inflammatory arthritis, including rheumatoid arthritis (RA) and psoriatic arthritis (PsA), elevates cardiovascular (CV) morbidity and mortality risks.
- While pharmacological and lifestyle interventions are recommended for CV risk management, their utilization rates and differences between RA and PsA patients remain unclear.
Purpose of the Study:
- To determine and compare the uptake of pharmacological and lifestyle management strategies for CV risk factors in RA and PsA patients.
- To identify factors associated with the utilization of these management strategies.
Main Methods:
- A survey was administered to online participants in the Australian Rheumatology Association Database.
- Data collected included medication use for hypertension, hyperlipidaemia, and diabetes, alongside self-reported height, weight, physical activity, and dietary changes.
- Management strategy use was compared between RA and PsA groups, with logistic regression used to identify associated factors.
Main Results:
- Of 858 RA and 161 PsA respondents, 93% with hypertension and 70% with hyperlipidaemia used pharmacological treatment.
- Adequate physical activity was reported by 50.8%, while only 27% of overweight/obese participants reported dietary changes.
- No significant differences in management strategy use were observed between RA and PsA patients; obesity and disease activity negatively impacted physical activity.
Conclusions:
- The majority of RA and PsA patients utilize pharmacological treatments for CV risk factors, but lifestyle modification uptake is low.
- There is a clear need for targeted lifestyle interventions to improve cardiovascular risk management in patients with RA and PsA.
Background:
Chronic inflammatory arthritis is associated with increased cardiovascular (CV) morbidity and mortality. Pharmacological management and healthy lifestyle modification is recommended to manage these risks, but it is not known how often these are utilised and whether there is any difference in their use between patients with different types of arthritis. The aim of this study was to determine and compare the proportion of participants with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) receiving pharmacological or lifestyle management strategies for CV risk factors. The secondary objective was to identify factors associated with use of management strategies.
Methods:
A survey was sent to online participants in the Australian Rheumatology Association Database, a voluntary national registry for inflammatory arthritis. Participants were asked whether they took medications for hypertension, hyperlipidaemia and diabetes, and to report their height, weight, level of physical activity, and dietary changes made. The use of management strategies was compared between participants with RA and PsA. Logistic regression analyses were performed to identify factors associated with physical activity and dietary changes.
Results:
There were 858 respondents with RA and 161 with PsA (response rate 64.5%). Pharmacological treatment was reported by 93% of participants with hypertension and 70% with hyperlipidaemia. All participants with diabetes reported being managed with dietary modification, pharmacological treatment, or a combination of both. Adequate physical activity was reported by 50.8%. Only 27% of overweight or obese participants reported making any dietary change for their health in the past year. There was no difference between RA and PsA in reported utilisation of management strategies. Hyperlipidaemia and being overweight were associated with making dietary change. Obesity and arthritis disease activity were negatively associated with physical activity.
Conclusions:
Most participants with RA and PsA reported using pharmacological treatment for CV risk factors. Relatively few reported using lifestyle modifications. Targeted lifestyle interventions should be implemented for RA and PsA patients.
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