Two studies presented in 2008 at the Congress of the European League Against Rheumatism found that people with RA had double the risk for heart disease, which was comparable to risk for people with type 2 diabetes. More studies in 2013 confirmed those findings, and also found that early treatment of RA could reduce the risk for heart disease.
More severe RA has a higher risk
Mayo Clinic studies presented in 2013 at the annual American College of Rheumatology meeting also found that patients with more severe RA are more likely to have heart problems. Particularly, people with severe RA had a higher risk within the first year of their disease. Researchers noted that the risk decreases as time goes on if RA is treated and managed well.
Women with early menopause and RA have a higher risk
Another study found that women with RA who experienced menopause before age 45 also seem to have a higher risk for cardiovascular disease. Researchers think that hormones may influence rheumatoid arthritis, which may in turn increase the risk for heart disease.
Body-wide inflammation may be a factor
Rheumatoid arthritis creates inflammation in the body that affects not only the joints, but also organs. This systemic inflammation may be the cause for increased risk of heart attack and stroke in people with RA.
Biologics may lower the cardiovascular risk
A 2012 study showed a remarkable reduction in heart attacks in people taking anti-TNF medication. The study looked at 100,000 people taking anti-TNF drugs over time, and found that the longer someone is treated with it, the lower their risk of heart disease. After one year, the risk was lowered by 24 percent, after two years by 42 percent and after three years by 56 percent.
People with RA should have annual cardiovascular risk screenings
Although people with RA generally go to the doctor frequently and are on treatments to control their inflammation, sometimes cardiovascular health gets lost in the mix. The Arthritis Foundation recommends that all RA patients be annually screened for cardiovascular risk. This is also true for ankylosing spondylitis and psoriatic arthritis patients.
Statins and anti-hypertensives should be considered
Experts say that treatment with statins and anti-hypertensives should be considered for patients with RA. In addition, cardiovascular management should be set according to guidelines, and treatment should be considered based on the new cardiovascular risk calculators that include RA as a risk factor.
Lifestyle changes may reduce risk
In addition to medication, lifestyle changes may help reduce the risk for heart disease. A balanced diet and exercise are two important factors, as well as stress management and quitting smoking.