Studies have shown that people with RA are at greater risk of heart disease and cardiovascular events the longer they have RA. Women with RA are twice as likely to have a heart attack (myocardial infarction) than women who do not. The risk increases to 3.10 in women who have had RA more than 10 years. RA suffers also have a higher mortality rate from cardiovascular events than the general population. This may be because RA patients have more frequent cardiovascular events (including heart attacks and strokes) than the general population, or because they have a higher risk of death over time.
A new study published in the July issue of Arthritis & Rheumatism has also found that people with RA have a high risk of death from their first heart attack than the general population. The researchers performed a retrospect study of hospital and health data in Australia to determine mortality rates over 30 days for people who suffered from a first cardiovascular event (heart attack or stroke). Of the nearly 30,000 patients included in the study, 359 had RA. The study found that the mortality rate for RA patients was 18.4%, while it was around 12% for non-RA patients. The study found that almost all of the deaths of the RA patients were due to heart attacks, not strokes. Demographically, the RA patients tended to be older and more were women. They also had lower rates of smoking and dyslipidemia (a disruption of the lipids in the blood such as elevated triglycerides and fats). However, they had higher rates of peripheral vascular disease, chronic pulmonary disease and renal disease, and the mortality rates for RA patients remained higher even after the researchers adjusted for these comorbidities. These patients were also more likely to have been recently diagnosed with congestive heart failure than those without RA.
The researchers suggested that these results might be due in part to elevated levels of inflammation from systemic arthritis, detrimental effects of arthritis drugs and other concurrent medications, larger size of the infarctions in the heart, or a delay in seeking medical treatment because the patients couldn’t identify the pain as a heart attack. They also found differences in the type of treatment given. RA patients were treated with angioplasty (PTCA) half as often as patients without RA. This could be explained by other studies that have found that RA patients have a different pattern of coronary disease, including coronary atherosclerosis and involvement of many vessels, making them poorer candidates for angioplasty.
The researchers concluded that more utilization of disease registries and better health data are required to further study health outcomes in patient populations. Further studies are also needed to study the possible reasons for the results that the study described. They also encouraged aggressive management of joint problems and systemic RA as well as cardiovascular screening and management as methods for reduce the risk of cardiovascular disease and death for RA patients.
Published On: July 21, 2006