RA & Heart Health: Systemic Inflammation Linked To Cardiovascular Disease

Patient Expert

If you have RA, you need to take steps to protect your heart. The traditional risk factors involved in heart disease include high blood pressure, diabetes, elevated cholesterol, a high BMI and smoking. In addition to these risk factors, RA patients are living with systemic inflammation. Mayo Clinic researchers believe that this inflammation may contribute to the increased risk of heart attack they see in RA patients.

Lene Andersen addresses the mortality gap in her book, "Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain", "Statistically, people with RA die sooner than others. When you have RA, you have a higher risk of co morbidities. This means other illnesses and conditions existing side by side with RA, such as hypertension (high blood pressure), heart disease and diabetes. The type of systemic inflammation and problems with the immune system that happen in RA seem to increase the risk of co morbidities and result in poorer outcomes."

Lene speculates that RA patients may not receive good preventive care because they are so busy trying to control their RA.  Sometimes ,"health maintenance can fall by the wayside," says Ms. Andersen.

Researches at Mayo Clinic stressed that RA patients need to be aware of their increased risk of cardiovascular disease, so that they can take steps to improve their cardiac health. They reported by the time RA patients receive their RA diagnosis, the risk of heart attack is already present.

Mayo Researchers recommended regular cardiac checkups for RA patients. Lowering blood pressure and cholesterol levels, as well as smoking cessation are important for everyone, especially those of us with RA.

One disturbing finding from this research is that people with RA often have no physical symptoms of heart disease. We don't seem to feel chest pain the same way people without RA experience chest pain. Perhaps, the researchers suggest, this is because RA patients have to take so many painkillers. They found that cardiac sudden death, may be the first sign of heart disease in those of us battling RA.

Web MD reports that angina or chest pain is the most common symptom associated with coronary artery disease. This is the type of pain that is often mistaken for heartburn or indigestion.

Symptoms of coronary artery disease include nausea, weakness, sweating, irregular heart beats and shortness of breath. I have had an irregular heartbeat for many years, and I do take medication to control it. Before my palpitations were diagnosed, I remember feeling as though there was a butterfly in my chest. It is important to report any strange or unusual symptoms to your doctor.

There are several signs a person may be having a heart attack. According to Web MD, they include pain or pressure in the chest, arm, or below the breastbone. You can also have pain or discomfort radiating to the jaw, throat, back or arm.

Some people may experience what they think is heartburn or indigestion, sweating, nausea, dizziness or vomiting. Shortness of breath is another significant sign, as well as extreme weakness, anxiety, and rapid or irregular heartbeats.

What can we do to lower our changes of having a heart attack or stroke? Web MD suggests the following:

  • Eat a heart-healthy diet low in fat & cholesterol

  • Maintain a healthy weight

  • Manage anger and stress

  • Keep diabetes tightly controlled

  • Quit smoking

  • Keep your cholesterol levels in check

  • Control high blood pressure.

Keeping active is also important, but we all know how difficult that is for many of us diagnosed with RA. Many of us have permanent joint damage because of aggressive disease or delayed diagnosis and treatment.

I wrestle with the idea of exercise constantly. Most days, I am not able to do anything but stretching exercises, but I do what I can. For many of us, swimming is the best exercise. It takes weight off of your joints and enables you to do things you simply could not do outside a pool. If you have the opportunity to swim for exercise, you may find it also helps eliminate mental stress.

My rheumatologist has never discussed heart disease with me, but she does know I see a cardiologist. Has your doctor ever discussed heart disease with you? Do you have a plan in place to keep your heart as healthy as possible?