Risk factors for cardiovascular disease in rheumatoid arthritis

Sherine E. Gabriel, Cynthia Crowson

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Purpose of review: To highlight recent evidence regarding the contribution of traditional and nontraditional [e.g. inflammatory markers, rheumatoid arthritis (RA) features] risk factors toward the excess cardiovascular risk in RA. Recent findings: The impact of traditional risk factors on the development of cardiovascular disease in persons with RA is an area of active research. Some are more prevalent among people with RA (e.g. smoking); others appear to have paradoxical relationships (e.g. body mass index), and findings remain inconsistent with others (e.g. dyslipidemia). Collectively the data suggest that cardiovascular risk factors behave differently in RA. Thus, risk scores developed for the general population based on traditional cardiovascular risk factors alone are unlikely to accurately estimate cardiovascular risk in RA, highlighting the need for RA-specific risk prediction tools.Nontraditional risk factors, in particular RA disease activity/severity measures, including inflammatory markers, disease activity scores, seropositivity, physical disability, destructive changes on joint radiographs, extra-articular manifestations, and corticosteroid use, have repeatedly shown significant associations with increased cardiovascular risk. Medications used to treat RA may also affect cardiovascular risk. A recent meta-analysis suggests that all nonsteroidal anti-inflammatory drugs confer some cardiovascular risk. The cardiovascular risks/benefits associated with use of disease-modifying antirheumatic drugs and/or biologics remain controversial, as does the role of statins in RA. Summary: Cardiovascular disease remains a major problem for people with RA. Future work should focus on further delineating the underlying biological mechanisms involved, developing and evaluating risk assessment tools and biomarkers, as well as prevention/treatment strategies specific to the RA population.

Original languageEnglish (US)
Pages (from-to)171-176
Number of pages6
JournalCurrent Opinion in Rheumatology
Volume24
Issue number2
DOIs
StatePublished - Mar 2012

Fingerprint

Rheumatoid Arthritis
Cardiovascular Diseases
Joints
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Antirheumatic Agents
Dyslipidemias
Biological Products
Population
Meta-Analysis
Adrenal Cortex Hormones
Body Mass Index
Anti-Inflammatory Agents
Biomarkers
Smoking

Keywords

  • cardiovascular risk factors
  • rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Risk factors for cardiovascular disease in rheumatoid arthritis. / Gabriel, Sherine E.; Crowson, Cynthia.

In: Current Opinion in Rheumatology, Vol. 24, No. 2, 03.2012, p. 171-176.

Research output: Contribution to journalArticle

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