Elevated resting heart rate in rheumatoid arthritis: possible role of physical deconditioning

Thirty-four patients with RA, 76 diabetic subjects (DM) and 67 healthy controls (CR) were studied in order to study cardiovascular autonomic function in RA. Valsalva manoeuvre, deep breathing test and active orthostatic test were used. Resting heart rate (resting HR) was markedly elevated in the RA and DM groups. Therefore, the groups were compared using analysis of variance with age and resting HR as covariates. The analyses showed no differences in cardiovascular responses between the RA group and CR group but cardiovascular responses were significantly diminished in the DM group compared with both the CR group and RA group. Our data indicate that the parasympathetic efferent pathway mediating cardiovascular reflexes via the nervus vagus is intact in RA. Thus elevated resting HR in RA does not seem to be due to peripheral parasympathetic damage. Physical deconditioning may explain the elevation of resting HR in patients with RA.