Cardiovascular disease risk in rheumatoid arthritis

Among health professionals r heumatoid arthritis is understood to be an autoimmune-driven disease of the synovial joints characterised by arthritis, arthralgia and early morning stiffness. What might not be known outside rheumatology circles is the high prevalence of cardiovascular disease (CVD) in this patient cohort. In rheumatoid arthritis, CVD results from a complex process of autoimmune-driven endothelial dysfunction. This in turn causes an acceleration in atherosclerosis of the coronary and cerebral arteries, leading to hypertension, myocardial infarction and stroke.

A meta-analysis conducted by Meune and colleagues pooled data from over 91 000 rheumatoid arthritis patients over a 40-year period anddemonstrated a 60% higher CVD-related mortality compared with the general population (Meune et al, 2009).

In patients with rheumatoid arthritis, regular screening and management of hyperlipidemia, hypertension, diabetes and obesity are vital to mitigate cardiovascular risk. Other variables, such as gender, age, ethnicity, family history and smoking status, also have an impact on an individual's CVD risk estimate.