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Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout

Romy Hansildaar1,2, Daisy Vedder1,2, Milad Baniaamam1,2

  • 1Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam and Reade, Amsterdam, Netherlands.

The Lancet. Rheumatology
|September 9, 2020
PubMed

Insights

Rheumatoid arthritis and gout increase cardiovascular risk, similar to rheumatoid arthritis. While urate-lowering therapy may help gout patients, evidence is inconsistent, necessitating better cardiovascular risk management.

Area of Science:

  • Rheumatology
  • Cardiology
  • Inflammation

Background:

  • Rheumatoid arthritis and gout are linked to increased cardiovascular morbidity and mortality.
  • Systemic inflammation plays a key role in both conditions and cardiovascular disease.
  • Gout is increasingly recognized as an independent cardiovascular risk factor.

Purpose of the Study:

  • To review the latest evidence on cardiovascular risk in rheumatoid arthritis and gout.
  • To evaluate the effectiveness of urate-lowering therapies on cardiovascular outcomes in gout.
  • To discuss cardiovascular disease risk management strategies for patients with these conditions.

Main Methods:

  • Literature review of recent studies on gout, rheumatoid arthritis, and cardiovascular disease.
  • Analysis of evidence regarding urate-lowering therapy and cardiovascular outcomes.
  • Discussion of current clinical guidelines and unmet needs in cardiovascular risk management.

Main Results:

  • Accumulating evidence suggests gout, like rheumatoid arthritis, is an independent cardiovascular risk factor.
  • Pathophysiological mechanisms of systemic inflammation overlap between gout and rheumatoid arthritis.
  • Data on the cardiovascular benefits of urate-lowering therapy in gout is often low-quality and contradictory.

Conclusions:

  • Cardiovascular disease risk management is essential for patients with rheumatoid arthritis and gout.
  • Further research is needed to clarify the role of urate-lowering therapies in reducing cardiovascular burden.
  • Implementation of evidence-based cardiovascular risk management strategies in clinical practice is crucial.

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