Abstract
BackgroundChronic inflammatory arthritis is associated with increased cardiovascular (CV) morbidity and mortality. Pharmacological management and healthy lifestyle modification is recommended to manage these risks, but it is not known how often these are utilised and whether there is any difference in their use between patients with different types of arthritis. The aim of this study was to determine and compare the proportion of participants with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) receiving pharmacological or lifestyle management strategies for CV risk factors. The secondary objective was to identify factors associated with use of management strategies.MethodsA survey was sent to online participants in the Australian Rheumatology Association Database, a voluntary national registry for inflammatory arthritis. Participants were asked whether they took medications for hypertension, hyperlipidaemia and diabetes, and to report their height, weight, level of physical activity, and dietary changes made. The use of management strategies was compared between participants with RA and PsA. Logistic regression analyses were performed to identify factors associated with physical activity and dietary changes.ResultsThere were 858 respondents with RA and 161 with PsA (response rate 64.5%). Pharmacological treatment was reported by 93% of participants with hypertension and 70% with hyperlipidaemia. All participants with diabetes reported being managed with dietary modification, pharmacological treatment, or a combination of both. Adequate physical activity was reported by 50.8%. Only 27% of overweight or obese participants reported making any dietary change for their health in the past year. There was no difference between RA and PsA in reported utilisation of management strategies. Hyperlipidaemia and being overweight were associated with making dietary change. Obesity and arthritis disease activity were negatively associated with physical activity.ConclusionsMost participants with RA and PsA reported using pharmacological treatment for CV risk factors. Relatively few reported using lifestyle modifications. Targeted lifestyle interventions should be implemented for RA and PsA patients.
Highlights
Chronic inflammatory arthritis is associated with increased cardiovascular (CV) morbidity and mortality
Previous analysis from the Australian Rheumatology Association Database (ARAD) showed that in this cohort, diabetes mellitus and high cholesterol were more common in participants with psoriatic arthritis (PsA) than rheumatoid arthritis (RA) [11]
Overall 1019 participants responded to the survey, including 858 with RA and 161 with PsA (Fig. 1)
Summary
Chronic inflammatory arthritis is associated with increased cardiovascular (CV) morbidity and mortality. Sinnathurai et al BMC Rheumatology (2018) 2:25 similar to that in general population controls [5, 6] It is not known whether this trend may be attributed to improved management of RA or more stringent screening and treatment for CV risk factors. In the Consortium of Rheumatology Researchers of North America (CORRONA) Registry, PsA was associated with higher rates of obesity, diabetes mellitus and hypertriglyceridaemia, compared with RA [12]. Due to this high prevalence of traditional CV risk factors in PsA, it might be expected that CV mortality in PsA might be increased at a rate similar to, or even higher than in RA. Other studies have found no increase in mortality compared with the general population [19, 20]
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