Patients with rheumatoid arthritis undoubtedly have a higher risk of cardiovascular events than people of the general population; however, we have shown that this risk does not depend on the height of the disease activity, told Dr. B. J. Radovits from Radboud University Nijmegen Medical Center. Probably, lower disease activity is already sufficient to cause an elevation of cardiovascular risk in rheumatoid arthritis patients.
In a case-control study conducted by Dr. Radovits and colleagues investigated patients with rheumatoid arthritis to known whether the level of disease activity is associated with the risk of myocardial infarction. The study included a subgroup with rheumatoid arthritis and myocardial infarction (cases) or rheumatoid arthritis only (controls.)
Rheumatoid arthritis patients with myocardial infarction were more often older and male when compared with control group. The authors reported that they also had a higher body mass index, total cholesterol, LDL cholesterol, triglycerides, and atherogenic index and lower HDL cholesterol levels.
Conversely, time-averaged disease activity scores and disease duration were associated to the risk of myocardial infarction.
In view of the currently available evidence, it is likely that traditional cardiovascular risk factors, as well as the chronic inflammatory processes, mediate the cardiovascular risk in patients with rheumatoid arthritis, the investigators write. The relative degree of inflammation seems not to contribute to the risk.
Rheumatologists should monitor carefully and treat effectively the traditional cardiovascular risk factors in patients with rheumatoid arthritis, Dr. Radovits concluded.