Top Rheumatoid Arthritis Stories of 2008

Smoking and Arthritis was a Hot Topic

• There have been several studies published this year and in the past few years linking smoking to a higher risk of developing RA.  Studies have also found that smokers who developed RA are more likely to have a positive rheumatoid factor, a hallmark of more severe disease.
• Results of a newer study published this past fall found that cigarette smoking could exacerbate rheumatoid arthritis in Africans Americans who have recently been diagnosed with the inflammatory joint disease.  Those who smoked were more likely to develop rheumatoid nodules. Rheumatoid nodules are growths under the skin and are often associated with more severe rheumatoid arthritis.  The smokers also tended to have higher levels of certain rheumatoid factor auto-antibodies in the blood.

Another Continuing Hot Topic- RA and Heart attack risks

• There have been a multitude of studies over the last several years linking RA to an increased risk o f heart attack and strokes and an increased risk of death from those events.  Researchers believe that the increased risk has to do with systemic inflammation of the blood vessels and tissues in the body related to the RA disease process.
• One study this year found that RA nearly doubles the risk of having a heart attack within the first 10 years of diagnosis. After adjusting for high blood pressure and diabetes, the Swedish researchers found that before their RA diagnosis, people were no more likely than others to have a heart attack. But after their diagnosis, their heart risks rose steadily.
• Another study from the Mayo Clinic found that the initial signs and symptoms of heart failure in people with RA are less obvious than in other patients even though people with RA have a higher death rate.  The researchers believe that this may lead to difficulty with diagnosis and proper management both RA and cardiovascular health.  They found that the 1-year mortality rate after heart failure in arthritis patients was 35 percent versus 19 percent in non-arthritis patients.
• Another study published in April found that men over age 50 with RA are at increased risk of suffering major cardiovascular events and that the level of RA disease activity predicts these events independent of traditional cardiovascular risk factors.  They found that 54% of men with high disease activity had cardiovascular events, compared to 26% of those with low disease activity.
• On the positive side, a study in the UK found that people with RA may be able to reduce their high risk of heart attacks and strokes if they follow a gluten-free, vegan diet.  The high fiber, low cholesterol nature of this lifestyle is believed to lower LDL (or the "bad") cholesterol and help decrease inflammation in the body.  The dietary menu included nuts, sunflower seeds, fruit and vegetables, millet and corn and sesame milk for calcium.  Saturated fats were not to make up more than 10% of daily energy intake, and wholegrain products were to be chosen as often as possible. The vegan participants also lowered their Body Mass Index (BMI).
• Also positive, in March, researchers published results of a study finding that people taking medications for RA may also be reducing their risk of heart attack and stroke in the process. They found that the time of exposure both to DMARDs and biological agents like TNF-inhibitors is associated with a reduction of the risk of cardiovascular events. For example, they determined that RA patients taking methotrexate for one year reduced their risk of heart attack by 18 percent and stroke by 11 percent.