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Cardiovascular Risk Factors before Onset of Rheumatoid Arthritis Are Associated with Cardiovascular Events after

Heidi Kokkonen¹, Linda Johansson¹, Hans Stenlund²

¹Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, 901 87 Umeå, Sweden.

Journal of Clinical Medicine

|November 11, 2022

Summary

Cardiovascular disease (CVD) risk factors present before rheumatoid arthritis (RA) onset increase the risk of future cardiovascular events (CVE) in RA patients. Early assessment of these risk factors is crucial for managing cardiovascular risk in individuals with RA.

Keywords:

cardiovascular disease rheumatoid arthritis risk factors

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Area of Science:

Rheumatology
Cardiology
Epidemiology

Background:

Rheumatoid arthritis (RA) significantly increases comorbidity and mortality, primarily due to cardiovascular disease (CVD).
Pre-RA individuals exhibit higher frequencies of CVD risk factors like elevated BMI, ApoB:A1 ratio, and smoking compared to controls.
Understanding the impact of pre-existing risk factors is vital for early intervention in RA patients.

Purpose of the Study:

To evaluate the influence of traditional cardiovascular risk factors identified before RA onset on the risk of cardiovascular events (CVE) post-diagnosis.
To compare the risk of CVE in pre-RA individuals with traditional risk factors against matched controls.

Main Methods:

A case-control study involving 521 pre-symptomatic individuals and 1566 controls from the Health Surveys of the Medical Biobank.
Assessment of CVD risk factors including hypertension, elevated ApoB:A1 ratio, BMI, diabetes, and smoking.
Utilized Swedish National Patient Register and Cause of Death Register for comorbidity and mortality data.

Main Results:

Pre-RA individuals demonstrated a 1.70-fold higher risk of future CVE compared to controls, persisting after adjustments (HR 1.73).
Multiple risk factors significantly amplified CVE risk in RA patients; two factors increased risk by 2.70-fold, and three to four factors by 6.32-fold.
Most individual risk factors were associated with CVE post-RA diagnosis.

Conclusions:

Cardiovascular risk factors present before RA onset are linked to an increased risk of future CVE.
Even after adjusting for risk factors and treatments, pre-RA individuals face a higher CVE risk.
Emphasizes the critical need for early cardiovascular risk assessment in individuals with or at risk for RA.