Rheumatoid arthritis as cardiovascular risk factor: an update

Calin D. Popa

doi:10.47803/rjc.2020.30.4.576

Abstract

Rheumatoid arthritis (RA) patients have a 1.5 – 2.5 higher chance to develop cardiovascular diseases (CVD), which in turn represent the most important cause of mortality and the most frequent comorbidity in these patients. Chronic inflammation crucially contributes to that, either as an independent risk factor or as a modulator of traditional cardiovascular (CV) risk factors, such as dyslipidemia and hypertension. The cardiovascular risk management (CVRM) is therefore essential in these patients. The implementation of it in the daily practice is quite challenging and requires a good networking between different specialists (rheumatologist, cardiologist, internist) and the general practitioners (GPs), and may get various forms of organization depending on region and locations.

Highlights

Rheumatoid arthritis (RA) is one of the most frequent chronic inflammatory diseases (1% from the general population)
RA is characterized by a polyarthritis that usually involves the small joints of the hands and feet, but larger joints such as the knees and hips could be affected
Other so called “extra-articular” manifestations can take place in RA, including rheumatic nodules, interstitial lung disease, subfebrile temperature or signs and symptoms related to other autoimmune disease RA can overlap with (Sjgören syndrome, vasculitis, myositis etc.)

Summary

Introduction

Rheumatoid arthritis (RA) is one of the most frequent chronic inflammatory diseases (1% from the general population). Rheumatoid arthritis (RA) is known to associate often with other comorbidities, mainly due to the presence of the chronic autoimmune processes. RA patients have a higher risk to develop various infections (parodontitis, urinary tract infections, gastro-enteritis, Epstein-Barr virus infection), malignancies (lymphoma’s, lung cancer) and cardiovascular diseases (CVD)[1]. The therapy of these patients using various immunosuppressive agents may have an important impact on the risk of comorbidities, either favoring their incidence (higher chance for infections for instance) or diminishing their chance of occurrence (lower risk of CVD)

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