RA & Heart Disease: Maintaining A Healthy Heart

Vanessa Collins Health Guide
  • Did you know that your risk of having a heart attack doubles in the ten years following your RA diagnosis?  This sobering bit of information from the American College Of Rheumatology started my  mind running. I wanted to know why we have a higher risk of heart attack.  I wanted to know what to do to keep our hearts healthy.


    We all know that RA is a serious disease.  Our overactive lymphocytes release chemicals called cytokines that cause cell destruction.  Most of the damage takes place in the joints, but the inflammation can, at times, be found in other parts of our bodies.


    When plaques form inside our arteries, we call it Atherosclerosis. Atherosclerosis is an inflammatory immune disorder.  Over the course of our lifetimes, plaques can build up inside our arteries.  If  the plaques break off, or if a blood clot forms on the plaques, the blood flow through the artery is blocked.  This is referred to as coronary artery disease, or CAD.  CAD increases our chance of heart attack, stroke, and sudden cardiac death.

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    Researchers don't know why those of us with RA have an increased chance of heart disease, but Atherosclerosis is thought to be an inflammatory immune disorder.  Heart disease and the risk of having a heart attack is linked to inflammation.  A high CRP level is linked to an increased chance of developing atherosclerosis.  The common element here seems to be an increased level of inflammation in our bodies.


    RA medications that are thought to increase our chances of developing heart disease include Prednisone, and other steroids, non-steroidal anti-inflammatory drugs (NSAIDs), and Celebrex.  I take 400 mg of Celebrex every day, even though I have high blood pressure.  I treat my hypertension and monitor it closely.  I take the Celebrex, because for me, the benefit outweighs the risk at this point.


    There are things we can do to decrease our risk of developing heart disease.  Exercise is one of the most beneficial things we can do for ours bodies.  Unfortunately, many of us find it hard to get out of bed, let alone exercise.


    I am one RA patient who cannot walk for exercise.  I am contemplating putting a medium-sized above-ground pool in my back yard this summer.  My RD wants me to swim, but I live in the country, and the nearest indoor pool is 30 miles away from my home.  An above-ground pool seems to be the best option for me. Besides, I don't want to put this body in a bathing suit out in public. I would feel much more comfortable at home.  Depending on your situation, this might be an option for you.


    We have all heard that we should eat our fresh fruit and vegetables. Eating a diet low in sodium, high in fresh fruits and vegetables, and high in lean protein is a healthy way to live.  That pretty much rules out eating at fast food restaurants.


    If you ever take a look at those nutrition charts that are posted in fast food restaurants, you will most likely find yourself shaking your head.  Most of the food you find in these places is full of fat and salt. Fortunately, many of the fast food chains are now offering salads and grilled chicken or fish, which is a better option than a heart attack on a plate, or, a burger and fries.


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    We all know that we need to maintain a normal weight. This one makes me cringe, because most of us take prednisone, and prednisone seems to pack on the weight.  Add our lack of mobility to the mix, and we have individuals struggling with obesity. As I mentioned above, eating a healthy diet and exercising as much as possible are two things we can do to try and maintain a healthy weight.


    All of us with RA need to be screened regularly for high blood pressure, high blood sugar and high cholesterol.  If we are are diagnosed with high readings in any of these areas, we can take medication to control these risk factors for heart disease.


    In the journal, Arthritis Research and Therapy, they report findings that DMARDs and biologics used to control the inflammation of RA may decrease our chances of heart disease. Working closely with our doctors to control our RA is key.


    I have an RD, an orthopedic doctor and a PCP on my medical team.  They work together and share information.  If you do not feel you are getting the care you need to control your RA, please seek a second opinion. Advocate for yourself so that you can get the best possible treatment for your RA, and for your heart.





Published On: May 14, 2012