Heart risk factors vary in affect in arthritis

NEW YORK (Reuters Health) - In rheumatoid arthritic patients, some traditional risk factors impart a greater risk of developing cardiovascular disease, while others confer a lower risk, compared with those without rheumatoid arthritis, according to a report in the Annals of the Rheumatic Diseases.

Dr. Sherine E. Gabriel from the Mayo Clinic, Rochester, Minnesota and colleagues note that cardiovascular disease is the underlying cause of death in many rheumatoid arthritis patients, but the impact of traditional cardiovascular risk factors in rheumatoid arthritis is unclear.

The team therefore compared the frequency of traditional cardiovascular risk factors in 603 rheumatoid arthritis patients and 603 subjects without rheumatoid arthritis and determined the impact of these risk factors on selected cardiovascular outcomes (heart attack, heart failure and cardiovascular-related death) in the two groups.

The initial prevalence of cardiovascular risk factors was similar in both groups, the authors report.

During an average follow-up of 15 years in the rheumatoid arthritis group and 17 years in the non-rheumatoid arthritis group, the rheumatoid arthritis patients were significantly more likely to loose weight and significantly less likely to develop abnormal lipid levels, such as high or low density cholesterol.

Gender, smoking status, and personal cardiac history had a different influence on cardiovascular outcome in the rheumatoid arthritis patients compared with the non-rheumatoid arthritis subjects. Specifically, male gender, current smoking, and personal cardiac history increased the risk of cardiovascular disease less in the rheumatoid arthritis patients than in those without rheumatoid arthritis.

"These results indicate that cardiovascular disease prevention strategies focused solely on controlling traditional cardiovascular risk factors may not have the same impact in persons with rheumatoid arthritis as would be expected based on estimates from the general population," the investigators note.

The weaker effect of some risk factors for cardiovascular disease in rheumatoid arthritis patients suggests that competing mechanisms have a role in the development of cardiovascular disease in these patients, they conclude. Additional research is needed to detect the underlying factors that determine rheumatoid arthritis-associated cardiovascular disease and mortality so therapeutic approaches can be developed.

SOURCE: Annals of the Rheumatic Diseases, January 2008.