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Changes in cardiovascular risk factors in patients with inflammatory arthritis following screening consultations-a
Julie Katrine Karstensen1, Sonja Wehberg2, Anja Bachmann1
1The Danish Center for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark.
Objectives:
Patients with chronic inflammatory arthritis (IA) (rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis) have an increased risk of cardiovascular disease (CVD). Although the European Alliance of Associations for Rheumatology (EULAR) recommends systematic cardiovascular risk (CVR) management in these patients, knowledge about whether CVR management programmes significantly reduce risk factors and, thus, overall CVR in patients with IA remains limited. This study evaluated changes in CVR factors following nurse-led screening consultations with a motivational approach for patients with IA based on the EULAR recommendations.
Methods:
In a register-based cohort study, patients who had participated in at least 2 nurse-led screening consultations at the Danish Hospital for Rheumatic Diseases between September 2011 and September 2015 were included. Data on CVR risk factors were collected and analysed for changes from the first to the second screening consultation.
Results:
There were 595 patients included, with a mean of 683 days between the first and second consultations. The odds ratios (ORs) for improvement vs aggravation of CVR risk factors were significant for smoking, OR of 0.41 (95% CI, 0.17-0.92), and body mass index (BMI) ≥ 25 kg/m2, OR of 0.46 (95% CI, 0.25-0.83). Improvements in glycated haemoglobin level, low-density lipoprotein cholesterol level, and systolic blood pressure did not reach statistical significance. Conversely, significant aggravation vs improvement was evident for changes in waist circumference, (OR 1.71; 95% CI, 1.05-2.84) and exercise (OR 1.93; 95% CI, 1.41-2.68).
Conclusions:
Although lifestyle change is difficult, we observed significant improvements in smoking and BMI after patients attended nurse-led screening consultations.