People with rheumatoid arthritis have a higher risk for developing heart disease than the general population; however, it is difficult to identify which patients are at increased risk. Researchers at Mayo Clinic have developed a simple approach to predict heart disease in these patients within ten years of their initial diagnosis of rheumatoid arthritis.
Previous research by the Mayo Clinic team identified a link between rheumatoid arthritis patients and increased risk for heart disease. A major challenge for physicians is detection and prevention of heart disease in rheumatoid arthritis patients who show no symptoms of heart disease. The goal of this latest study is to find a way to detect the risk of heart disease earlier in patients with rheumatoid arthritis.
"Rheumatoid arthritis sufferers are dealing with significant pain and stress, therefore cardiovascular disease prevention may be delayed," says Hilal Maradit Kremers, M.D., lead study investigator and research associate in the Mayo Clinic Department of Health Sciences Research, "Our findings indicate that evaluation of cardiovascular risk based on risk factor profiles of individual patients can help physicians identify high risk rheumatoid arthritis patients and assist with decisions concerning cardiovascular disease prevention."
Mayo Clinic researchers estimated the 10-year absolute risk of cardiovascular disease in a group of 553 patients diagnosed with rheumatoid arthritis and compared them with 574 patients of the same age and gender who did not have rheumatoid arthritis. The researchers collected detailed information about all study subjects' cardiac events and their traditional cardiovascular risk factors: diabetes, blood pressure, cholesterol, body mass index and smoking.
Using absolute risk analysis methods, researchers discovered that 85 percent of those 60 to 69 year olds who were newly diagnosed with rheumatoid arthritis patients had a 1 in 5 chance of developing a serious cardiovascular event, compared to only 40 percent of patients who did not have rheumatoid arthritis. In each age group, cardiovascular risk in rheumatoid arthritis patients was similar to that of nonrheumatoid arthritis subjects who were 5-10 years older.
"These results emphasize the importance of performing a comprehensive cardiovascular risk assessment for all newly diagnosed rheumatoid arthritis patients," says Sherine Gabriel, M.D., the study's senior author and Mayo Clinic rheumatologist and epidemiologist.
Rheumatoid arthritis is a chronic, autoimmune disease that causes pain, swelling, stiffness and loss of function in multiple joints. Rheumatoid arthritis is a systemic disease and also may affect other organs of the body including the lungs, heart and kidneys. Rheumatoid arthritis affects about 2.1 million Americans, mostly women and generally striking between the ages of 20 and 50.
The findings of this Mayo Clinic research study are being presented at the American College of Rheumatology Annual Scientific Meeting in Boston, Nov. 6-11, 2007.
Members of the Mayo Clinic study team include: Hilal Maradit-Kremers, M.D., Cynthia Crowson, Terry Therneau, Ph.D; Veronique Roger, M.D., and Sherine Gabriel, M.D. Their work was supported by grants from the National Institutes of Health; in particular, the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
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