Cardiovascular risk present across chronic rheumatic diseases

By Liam Davenport, MedWire Reporter

Patients across the spectrum of rheumatic diseases, not just those with rheumatoid arthritis (RA), have a significantly increased prevalence of cardiovascular risk factors compared with the general population, the results of a Dutch study indicate.

Chronic rheumatic and cardiovascular disease share common pathophysiologic factors, and rheumatic diseases are commonly treated with anti-inflammatory drugs. However, the majority of studies on cardiovascular morbidity and mortality have been conducted in RA patients, with little investigation into associations with other chronic rheumatic diseases.

To investigate further, Inger Meek, from Arthritis Center Twente in Enschede, and colleagues studied 546 RA patients, 129 gout patients, 168 osteoarthritis (OA) patients, 85 patients with connective-tissue disease (CTD), 91 polymyalgia rheumatica (PMR) patients, and 214 patients with chronic localized or generalized pain syndromes (CPSs), all aged 36-75 years, as well as a random sample of 4523 individuals from the population-based Doetinchem Cohort health study (DCS).

Compared with the DCS cohort, RA patients were significantly more likely to be overweight or obese, have hypertension, and be current smokers, at odds ratios of 1.3, 1.4, 1.3, and 1.5, respectively, as were those with gout, at respective odds ratios of 6.6, 4.7, 2.7, and 1.5. In addition, gout patients were the only group to also have an increased prevalence of unfavorable cholesterol profiles, at an odds ratio of 1.5.

The results, published in Rheumatology, reveal that cardiovascular risk factors were also increased in OA patients, who had a significantly increased prevalence of hypertension, overweight, and obesity, while PMR patients had a significantly increased prevalence of obesity and hypertension.

CPS patients had a significantly increased prevalence of current smoking, overweight, obesity, and hypertension compared with individuals from the DCS cohort, and they were more likely to be prescribed statins.

Interestingly, the team observed that CTD patients had a more favorable total to high-density lipoprotein cholesterol ratio than DCS individuals, and that CPS patients had more favorable total cholesterol values.

They write: "This study shows that cardiovascular risk factors are over-represented in all the rheumatic diseases studied. There may be different patterns of risk factors in specific rheumatic diseases.

"Overweight and hypertension were consistently present in all rheumatic diseases studied. RA patients are further characterized by a high prevalence of smoking, whereas gout patients show an increase in all risk factors measured."

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