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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Cardiovascular risk factors associated with polymyalgia rheumatica and giant cell arteritis in a prospective cohort:
Max Yates1, Robert Luben2, Shabina Hayat2
1Centre for Epidemiology Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich.
Insights
Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) share common risk factors with vascular disease. Identifying these shared risk factors may help prevent PMR and GCA by modifying cardiovascular risk.
Area of Science:
- Rheumatology
- Cardiovascular Medicine
- Epidemiology
Background:
- Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are linked to an elevated risk of vascular disease.
- The causal relationship between PMR/GCA and vascular disease, or a shared underlying predisposition, requires further investigation.
Purpose of the Study:
- To determine if established cardiovascular risk factors contribute to the incidence of PMR and GCA.
Main Methods:
- A population-based cohort study analyzed clinical records using keyword searches to identify PMR and GCA cases.
- Cox proportional hazards models assessed associations between cardiovascular risk factors and incident PMR/GCA.
Main Results:
- Over 315,022 person-years, 395 PMR and 118 GCA diagnoses were recorded.
- Elevated diastolic blood pressure (>90 mmHg) correlated with increased PMR risk (HR=1.35).
- Ever-smoking was associated with a higher risk of GCA (HR=2.01).
Conclusions:
- PMR and GCA share common risk factors with vascular disease, suggesting an underlying shared susceptibility.
- These findings highlight potential disease prevention strategies focused on modifying cardiovascular risk factors.
Objectives:
PMR and GCA are associated with increased risk of vascular disease. However, it remains unclear whether this relationship is causal or reflects a common underlying propensity. The aim of this study was to identify whether known cardiovascular risk factors increase the risk of PMR and GCA.
Methods:
Clinical records were examined using key word searches to identify cases of PMR and GCA, applying current classification criteria in a population-based cohort. Associations between cardiovascular risk factors and incident PMR and GCA were analysed using Cox proportional hazards.
Results:
In 315 022 person years of follow-up, there were 395 incident diagnoses of PMR and 118 incident diagnoses of GCA that met the clinical definition. Raised diastolic blood pressure (>90 mmHg) at baseline/recruitment was associated with subsequent incident PMR [hazard ratio=1.35 (95% CI 1.01, 1.80) P=0.045], and ever-smoking was associated with incident GCA [hazard ratio=2.01 (95% CI 1.26, 3.20) P=0.003]. Estimates were similar when the analysis was restricted to individuals whose diagnoses satisfied the current classification criteria sets.
Conclusion:
PMR and GCA shares common risk factors with vascular disease onset, suggesting a common underlying propensity. This may indicate a potential for disease prevention strategies through modifying cardiovascular risk.
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