Abstract
BackgroundRheumatoid arthritis (RA) is a systemic autoimmune disease with multiple known comorbidities and risk factors. The rate and severity of different comorbidities among RA patients are influenced by various demographic, behavioral, and socioeconomic factors, which can vary widely between urban and rural areas. However, limited information is currently available regarding the association of comorbidities with RA in rural settings. In this study, we investigated the prevalence of common comorbidities and risk factors of RA among RA patients from a rural hospital located in rural northern New York and compared them against national patient records obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS).MethodologyWe compared de-identified patient records of 153 RA patients obtained from St. Lawrence Health (SLH) to 198 RA patients from the NHAMCS. After performing the descriptive analyses and removing outliers, two-sample tests of proportions were used for comparing the binary categories of sex, age, obesity, hypertension, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF) between the two datasets. These analyses were applied to both weighted and unweighted sets of national data, and a p-value of <0.05 was considered statistically significant. The differences were then explored at a greater resolution by binning body mass index, blood pressure (BP), COPD prevalence, and tobacco usage data across different age groups.ResultsA significantly higher rate of diastolic hypertension (χ2 = 17.942, w = 0.232, p < 0.001) and over two times higher prevalence of COPD (χ2 = 7.635, w = 0.147, p = 0.006) were observed among RA patients in the rural group. The rates of CHF were significantly different only when sample weighting was applied. When categorized by age groups, diastolic BP showed a peak at 40-49 years, coinciding with the age group for high tobacco smoking and peak disease activity in rural RA patients.ConclusionsA higher prevalence of comorbidities of RA such as hypertension (diastolic) and COPD are observed in patients from northern rural New York compared to the national average. Our findings indicate that rural RA patients might have a distinct comorbidity burden, suggesting the need for larger-scale studies.
Highlights
Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting approximately 0.5-1% of the population and is the most common disease observed in rheumatology clinics [1,2]
When categorized by age groups, diastolic blood pressure (BP) showed a peak at 40-49 years, coinciding with the age group for high tobacco smoking and peak disease activity in rural RA patients
A higher prevalence of comorbidities of RA such as hypertension and chronic obstructive pulmonary disease (COPD) are observed in patients from northern rural New York compared to the national average
Summary
Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting approximately 0.5-1% of the population and is the most common disease observed in rheumatology clinics [1,2]. Comorbidities have profound impacts on the disease activity of RA in the body, often substantially increasing pain and mortality. Several of these comorbid conditions are known to increase the risk of developing RA and its progression [8,10,11]. The impact of lifestyle and behavioral factors on RA has been investigated, and tobacco smoking has been shown to have a strong association with. Rheumatoid arthritis (RA) is a systemic autoimmune disease with multiple known comorbidities and risk factors. We investigated the prevalence of common comorbidities and risk factors of RA among RA patients from a rural hospital located in rural northern New York and compared them against national patient records obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS)
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