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Managing Cardiovascular Risk in Patients with Rheumatic Disease

Lyn D Ferguson1, Naveed Sattar1, Iain B McInnes2

  • 1Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.

Rheumatic Diseases Clinics of North America
|April 11, 2022
PubMed

Insights

Individuals with rheumatoid arthritis, lupus, or gout face higher cardiovascular disease (CVD) risks. Managing inflammation and traditional risk factors is key to reducing morbidity and mortality from CVD.

Area of Science:

  • Rheumatology
  • Cardiology
  • Public Health

Background:

  • Rheumatoid arthritis, systemic lupus erythematosus, and gout significantly increase cardiovascular disease (CVD) risk compared to the general population.
  • This elevated risk stems from a complex interplay of traditional cardiovascular risk factors and unique disease-specific mechanisms.
  • Cardiovascular disease is a leading cause of morbidity and mortality, underscoring the importance of proactive screening and management in at-risk populations.

Purpose of the Study:

  • To highlight the increased cardiovascular disease risk in patients with rheumatoid arthritis, systemic lupus erythematosus, and gout.
  • To outline essential strategies for managing cardiovascular disease in these patient groups.
  • To emphasize the importance of individualized risk assessment for initiating cardiovascular therapies.

Main Methods:

  • Review of existing literature and clinical guidelines concerning cardiovascular risk in inflammatory autoimmune diseases.
  • Analysis of disease-specific factors contributing to cardiovascular risk.
  • Discussion of management strategies encompassing disease activity control, medication judiciousness, and traditional risk factor modification.

Main Results:

  • Patients with rheumatoid arthritis, lupus, or gout exhibit a heightened susceptibility to cardiovascular events.
  • Effective management requires a dual approach: controlling underlying inflammatory conditions and addressing conventional cardiovascular risk factors.
  • Minimizing exposure to nonsteroidal anti-inflammatory drugs and long-term high-dose corticosteroids is crucial for mitigating iatrogenic cardiovascular risk.

Conclusions:

  • Tight control of autoimmune disease activity is paramount in reducing inflammation-driven cardiovascular risk.
  • Comprehensive management of traditional cardiovascular risk factors through lifestyle changes and pharmacotherapy is essential.
  • Therapeutic decisions for antihypertensive and lipid-lowering agents should be guided by an individual's overall CVD risk profile.

Keywords:
Cardiovascular disease (CVD)GoutInflammationRASLE

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