When you have rheumatoid arthritis (RA), you have a higher risk of heart attack and stroke. RA is a systemic illness that affects not just joints, but also tendons, the vascular system and internal organs, such as your heart. This systemic inflammation can be a contributing factor to that increased risk of heart attack and affects the mortality gap–on average, people with RA have a life expectancy 10 years shorter than people who don’t have RA.
Another factor is that people with RA often don’t receive optimal primary care. This is likely because RA takes up so much time that preventative healthcare receives less attention. As many primary care physicians may not be aware of the systemic nature of the disease, this can increase the risk of other health problems.
What you can do to prevent heart attack
The same medications used to suppress RA also suppress systemic inflammation. Studies have shown that biologics, which have led to increased rates of remission or low disease activity, have also had a significant impact on the risk of heart attack and stroke in people with RA. In other words, treating RA can lower risk of heartdisease. Even if a person is having trouble finding a medication that fully suppresses RA, taking the meds will likely help reduce systemic inflammation.
Other factors that can help reduce the risk are controlling cholesterol levels and blood pressure. Also, it’s important to focus on preventing or managing diabetes. It’s a good idea to get a referral to a preventative cardiologistand talk with him or her about stress tests and other methods of regular monitoring well before others your age do so. Maintaining a healthy weight is a key factor in preventing heart problems. This can be an extra challenge for people with RA who may have trouble moving or who are taking medications that can cause weight gain. Ask your doctor for a referral to a nutritionist who can help you put together a healthy diet and talk to you about portion sizes.
Physical activity is also essential, not just in terms of improving your heart health, but in maintaining your mobility. You don’t have to join a gym or run triathlons to be fit. The American Heart Association recommends at least 30 to 45 minutes of any physical activity a day. That can sound like a lot to someone who lives with RA, chronic fatigue and chronic pain, but the key here is the word "any."
The kind of physical activity you do depends on the level of your RA and what kind of day you’re having. Not all of us will be able to meet the 30 to 45 minute goal, but every little bit helps. On bad days, having a shower and getting dressed counts. On better days, a post-dinner walk around the neighborhood, vacuuming the living room or exercising in a heated pool can do the trick. Talk to your rheumatologist about a referral to a physical therapist who can put together an exercise program that works for you. You can also watch our exercise and RA video, in which the RA site team demonstrates how to keep moving with different levels of RA.
Symptoms of heart attack
Should you have a heart attack, fast medical attention can lower the long-term impact or save your life. Familiarize yourself with the symptoms of a heart attack:
- Pain, discomfort, a sense of pressure or fullness in the middle of the chest. This can last a while or go away and come back again
- Discomfort or pain in other areas of the body, including arms, stomach, back, neck and jaw
- Shortness of breath
- Cold sweat, nausea, lightheadedness.
- Women are more likely to experience a sense of pressure, nausea and vomiting, or pain in the back or jaw
If you have symptoms of a heart attack, call 911. Do not drive to the ER or have someone else drive you. If you lose consciousness or have another heart attack, the paramedics can help you survive. Your spouse or a cab driver cannot.
Awareness saves lives
People with RA live with a disease that affects many parts of their bodies, not just the joints. Being a good advocate for yourself means you are an integral part of managing your health and making decisions that reduce your risk of developing other conditions. Stay informed about RA and its potential impact on all areas of your health. Keep an ongoing dialogue with your family doctor and rheumatologist about the systemic impact of RA. This will help ensure that preventative healthcare doesn’t get overlooked.
Lene Andersen is the Community Leader for HealthCentral’s RA Community. Lene (pronounced Lena) is an award-winning writer, health and disability advocate, and photographer living in Toronto. She’s written several books, including Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain, and 7 Facets: A Meditation on Pain, as well as the award-winning blog, The Seated View. Follow Lene on Twitter @TheSeatedView and on Facebook. Watch her story on HealthCentral.