Abstract
Introduction: Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge. Objective: We conducted this research with the aim to explore the association between CIRD and cardiovascular risk in a Cameroonian population based on the World Health Organization (WHO) and International Society for Hypertension (ISH) risk charts. Methods: This cross-sectional study included CIRD patients, followed at the rheumatology unit of the Yaounde Central Hospital, and, who were matched to non-CIRD subjects for sex, age and race. Cardiovascular risk factors were studied and subsequently the cardiovascular risk was estimated using the WHO/ISH risk charts. Analyses were performed in Epi-info and SPSS software and results were considered statistically significant for a p-value less than 0.05. Results: In total, 109 CIRD patients and 111 non-CIRD subjects were included. Their respective mean ages were 44.4 ± 15.2 years and 44.2 ± 15.1 years. Odds ratio 2.09, 95% confidence interval (CI) (1.07 - 4.08); high BMI OR 1.89, 95% CI (1.1 - 3.24); diabetes mellitus (p = 0.03) and physical inactivity (p < 0.001) were all markedly found in CIRD patients compared with controls. Ten (9.2%) CIRD patients had a past history of atherosclerotic cardiovascular events compared with no control (p < 0.001). The cardiovascular risk estimated with the WHO/ISH risk charts was low in 43 (79.6%) patients with CIRD versus 52 (88.1%) non-CIRD subjects. Conclusions: CIRD were associated with hypertension, excess overall adiposity, diabetes mellitus, and physical inactivity. A substantially increased proportion of CIRD patients with a past history of atherosclerotic cardiovascular events were noted. But the WHO/ISH risk charts broadly found a similar and globally decremented cardiovascular risk in both study groups, highlighting the need to pursue research for definite conclusions on their reliability.
Highlights
Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge
The cohort comprises a large array of CIRD that were all included in this research: 1) rheumatoid arthritis (RA) diagnosed according to the American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) criteria [10] [11], 2) systemic lupus erythematosus (SLE) and 3) systemic sclerosis both diagnosed with respect to their respective ACR criteria [12] [13], 4) mixed connective tissue disease fulfilled the Sharp criteria [14], 5) Sjögren’s syndrome (SS) diagnosed as recommended by the American-European consensus group criteria [15], 6) autoimmune polymyositis fulfilled the Hoogendjick et al criteria [16], 7) spondyloarthropathies diagnosed according to the Amor et al criteria [17], 8) and adult onset Still’s disease diagnosed according to the Fautrel et al criteria [18]
For cardiovascular risk factors (Table 2), hypertension was recorded in 27.5% of the CIRD patients and 15.3% of the non-CIRD subjects “odds ratios (OR) 2.09, 95% confidence interval (CI) (1.07 - 4.08), p = 0.03” excess overall adiposity reflected by high Body Mass Index (BMI) was found in 63.3% of the CIRD subjects and 47.7% of the non-CIRD participants [“OR 1.89, 95% CI (1.1 - 3.24), p = 0.02” diabetes mellitus and physical inactivity were significantly noticed only in the CIRD group (7.3%, p = 0.003 and 11%, p < 0.001 for diabetes and physical inactivity respectively)
Summary
Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge. Methods: This cross-sectional study included CIRD patients, followed at the rheumatology unit of the Yaounde Central Hospital, and, who were matched to non-CIRD subjects for sex, age and race. Results: In total, 109 CIRD patients and 111 non-CIRD subjects were included. Their respective mean ages were 44.4 ± 15.2 years and 44.2 ± 15.1 years. Nontraditional cardiovascular risk factors are essentially genetic/epigenetic mechanisms, disease-modifying antirheumatic drugs, and immune mechanisms together with chronic inflammation [1] [6]
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