Best Practice & Research Clinical Rheumatology
Volume 23, Issue 1 , Pages 71-82 , February 2009

Cardiovascular co-morbidity in early rheumatoid arthritis

  • Holly John, BMBS, MRCP (Clinical Research Fellow & Specialist Registrar)

      Affiliations

    • Department of Rheumatology, Dudley Group of Hospitals NHS Trust, UK
    • School of Sport and Exercise Sciences, University of Birmingham, UK
    • ,
  • George Kitas, MD, PhD, FRCP (Professor of Rheumatology)

      Affiliations

    • Department of Rheumatology, Dudley Group of Hospitals NHS Trust, UK
    • ARC Epidemiology Unit, University of Manchester, UK
    • ,
  • Tracey Toms, MBChB, MRCP (Clinical Research Fellow & Specialist Registrar)

      Affiliations

    • Department of Rheumatology, Dudley Group of Hospitals NHS Trust, UK
    • ARC Epidemiology Unit, University of Manchester, UK
    • ,
  • Nicola Goodson, MBChB, PhD, FRCP (Senior Lecturer in Rheumatology)

      Affiliations

    • Department of Rheumatology, University Hospital Aintree Hospitals NHS Trust, Liverpool, UK
    • ARC Epidemiology Unit, University of Manchester, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 151 529 5889; Fax: +44 151 529 5888.

References 

  1. Michaud K, Wolfe F. Comorbidities in rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2007;21:885–906
  2. Symmons DP, Jones MA, Scott DL, Prior P. Longterm mortality outcome in patients with rheumatoid arthritis: early presenters continue to do well. J Rheumatol. 1998;25:1072–1077
  3. Naz SM, Symmons DP. Mortality in established rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2007;21:871–883
  4. van Doornum S, McColl G, Wicks IP. Accelerated atherosclerosis. An extraarticular feature of rheumatoid arthritis. Arthritis Rheum. 2002;46:862–873
  5. Charcot JM. Clinical lectures on senile and chronic disease. 95. London: New Syddenham Society; 1881;164–79
  6. Turesson C, O'Fallon WM, Crowson CS, et al. Occurrence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol. 2002;29:62–67
  7. Goodson N. Coronary artery disease and rheumatoid arthritis. Curr Opin Rheumatol. 2002;14:115–120
  8. Stevens RJ, Douglas KM, Saratzis AN, Kitas GD. Inflammation and atherosclerosis in rheumatoid arthritis. Expert Rev Mol Med. 2005;7:1–24
  9. Goodson N, Marks J, Lunt M, Symmons D. Cardiovascular admissions and mortality in an inception cohort of patients with rheumatoid arthritis with onset in the 1980s and 1990s. Ann Rheum Dis. 2005;64:1595–1601
  10. Hakoda M, Oiwa H, Kasagi F, et al. Mortality of rheumatoid arthritis in Japan: a longitudinal cohort study. Ann Rheum Dis. 2005;64:1451–1455
  11. Kitas GD, Erb N. Tackling ischaemic heart disease in rheumatoid arthritis. Rheumatology. 2003;42:607–613
  12. Bjornadal L, Baecklund E, Yin L, et al. Decreasing mortality in patients with rheumatoid arthritis: results from a large population based cohort in Sweden, 1964-95. J Rheumatol. 2002;29:906–912
  13. Wolfe F, Freundlich B, Straus WL. Increase in cardiovascular and cerebrovascular disease prevalence in rheumatoid arthritis. J Rheumatol. 2003;30:36–40
  14. Maradit-Kremers H, Crowson CS, Nicola PJ, et al. Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis. Arthritis Rheum. 2005;52:402–411
  15. Solomon DH, Goodson NJ, Katz JN, et al. Patterns of cardiovascular risk in rheumatoid arthritis. Ann Rheum Dis. 2006;65:1608–1612
  16. Banks MJ, Flint EJ, Bacon PA, Kitas G. Rheumatoid arthritis is an independent risk factor for ischaemic heart disease. Arthritis Rheum. 2000;43:S385
  17. McEntegart A, Capell H, Creran D, et al. Cardiovascular risk factors, including thrombotic variables, in a population with rheumatoid arthritis. Rheumatology. 2001;40:640–644
  18. Wislowska M, Sypula S, Kowalick I. Echocardiographic findings, 24 hour electrocardiographic holter monitoring in patients with rheumatoid arthritis according to Steinbocker's criteria, functional index, value of Waaler-Rose titre and duration of disease. Clin Rheumatol. 1998;17:369–377
  19. Douglas KM, Pace AV, Treharne GJ, et al. Excess recurrent cardiac events in rheumatoid arthritis patients with acute coronary syndrome. Ann Rheum Dis. 2006;65:348–353
  20. van Doornum S, Brand C, King B, Sundararajan V. Increased case fatality rates following a first acute cardiovascular event in patients with rheumatoid arthritis. Arthritis Rheum. 2006;54:2061–2068
  21. Sodergren A, Stegmayr B, Lundberg V, et al. Increased incidence of and impaired prognosis after acute myocardial infarction among patients with seropositive rheumatoid arthritis. Ann Rheum Dis. 2007;66:263–266
  22. Hall FC, Dalbeth N. Disease modification and cardiovascular risk reduction: two sides of the same coin?. Rheumatology. 2005;44:1473–1482
  23. Erb N, Pace AV, Douglas KM, et al. Risk assessment for coronary heart disease in rheumatoid arthritis and osteoarthritis. Scand J Rheumatol. 2004;33:293–299
  24. Panoulas VF, Metsios G, Pace AV, et al. Hypertension in rheumatoid arthritis. Rheumatology. 2008;47:1286–1298
  25. Nurmohamed MT. Atherogenic lipid profiles and its management in patients with rheumatoid arthritis. Vasc Health Risk Manag. 2007;3:845–852
  26. Park YB, Lee SK, Lee WK, et al. Lipid profiles in untreated patients with rheumatoid arthritis. J Rheumatol. 1999;26:1701–1704
  27. Boers M, Nurmohamed MT, Doelman CJA, et al. Influence of glucocorticoids and disease activity on total and high density lipoprotein cholesterol in patients with rheumatoid arthritis. Ann Rheum Dis. 2003;62:842–845
  28. Popa C, van den Hoogen FH, Radstake TR, et al. Modulation of lipoprotein plasma concentrations during long-term anti-TNF therapy in patients with active rheumatoid arthritis. Ann Rheum Dis. 2007;66:1503–1507
  29. Metsios G, Stavropoulos-Kalinoglou A, Douglas KM, et al. Blockade of tumour necrosis factor alpha in rheumatoid arthritis: effects on components of rheumatoid cachexia. Rheumatology. 2007;46:1824–1827
  30. Stavropoulos-Kalinoglou A, Metsios G, Koutedakis Y, et al. Redefining overweight and obesity in rheumatoid arthritis patients. Ann Rheum Dis. 2007;66:1316–1321
  31. Doran M. Rheumatoid arthritis and diabetes mellitus: evidence for an association?. J Rheumatol. 2007;34:460–462
  32. Svenson KL, Lundqvist G, Wide L, Hallgren R. Impaired glucose handling in active rheumatoid arthritis: relationship to the secretion of insulin and counter-regulatory hormones. Metabolism. 1987;36:940–943
  33. Douglas KM, Sattar N, Kitas GD. Potential role of statins and PPARs in rheumatoid arthritis. Future Rheumatol. 2006;1:259–274
  34. Goodson N, Farragher T, Symmons DP. Rheumatoid factor, smoking and disease severity: associations with mortality in rheumatoid arthritis. J Rheumatol. 2008;36:945–949
  35. Carnethon MR, Gulati M, Greenland P. Prevalence and cardiovascular disease correlates of low cardiorespiratory fitness in adolsecents and adults. JAMA. 2005;294:2981–2988
  36. Metsios G, Stavropoulos-Kalinoglou A, Veldhuijzen van Zanten J, et al. Rheumatoid arthritis, cardiovascular disease and physical exercise: a systematic review. Rheumatology. 2008;47:239–248
  37. Sattar N, McInnes IB. Vascular comorbidity in rheumatoid arthritis: potential mechanisms and solutions. Curr Opin Rheumatol. 2005;17:286–292
  38. Gonzalez A, Maradit-Kremers H, Crowson CS, et al. Do cardiovascular risk factors confer the same risk for cardiovascular outcomes in rheumatoid arthritis patients as in non-rheumatoid arthritis patients?. Ann Rheum Dis. 2008;67:64–69
  39. Ross R. Atherosclerosis–an inflammatory disease. N Engl J Med. 1999;340:115–126
  40. Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med. 2004;350:1387–1397
  41. Goodson NJ, Symmons DP, Scott DG, et al. Baseline levels of C-reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis: a ten-year follow up study of a primary care-based inception cohort. Arthritis Rheum. 2005;52:2293–2299
  42. van Leuven SI, Franssen R, Kastelein JJ, et al. Systemic inflammation as a risk factor for atherothrombosis. Rheumatology. 2007;47:3–7
  43. Choi HK, Hernan MA, Seeger JD, et al. Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet. 2002;359:1173–1177
  44. Suissa S, Bernatsky S, Hudson M. Antirheumatic drug use and the risk of acute myocardial infarction. Arthritis Care Res. 2006;55:531–536
  45. Dixon WG, Watson KD, Lunt M, et al. Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: results from the British Society for Rheumatology Biologics Register. Arthritis Rheum. 2007;56:2905–2912
  46. Avouac J, Allanore Y. Cardiovascular risk in rheumatoid arthritis: effects of anti-TNF drugs. Expert Opin Pharmacother. 2008;9:1121–1128
  47. Douglas KM, Panoulas VF, Smith J, et al. The relationship of inflammatory and genetic factors with fibrinolysis in rheumtaoid arthritis. Rheumatology. 2007;46(Suppl. 1):i47
  48. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315–324
  49. Harrison BJ, Symmons DP, Barrett EM, Silman AJ. The performance of the 1987 ARA classification criteria for rheumatoid arthritis in a population based cohort of patients with early inflammatory polyarthritis. American Rheumatism Association. J Rheumatol. 1998;25:2324–2330
  50. Dixon WG, Symmons DP. Does early rheumatoid arthritis exist?. Best Pract Res Clin Rheumatol. 2005;19:37–53
  51. van Aken J, van Bilsen JHM, Allaart CF, et al. The Leiden early arthritis clinic. Clin Exp Rheumatol. 2003;21(Suppl. 31):S100–S105
  52. Cush JJ. Early rheumatoid arthritis - is there a window of opportunity?. J Rheumatol. 2007;34(Suppl. 80):1–7
  53. Scott DL. Early rheumatoid arthritis. Br Med Bull. 2007;81–8297–114
  54. Emery P. Treatment of rheumatoid arthritis. BMJ. 2006;332:152–155
  55. Raza K, Buckley CE, Salmon M, Buckley CD. Treating very early rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2006;20:849–863
  56. Veldhuijzen van Zanten J, Kitas GD. Inflammation, carotid intima-media thichkness and atherosclerosis in rheumatoid arthritis. Arthritis Res Ther. 2008;10:102
  57. Kumeda Y, Inaba M, Goto H, et al. Incraesed thickness of the arterial intima-media detected by ultrasonography in patients with rheumatoid arthritis. Arthritis Rheum. 2002;46:1489–1497
  58. Del Porto F, Lagana B, Lai S, et al. Response to anti-tumour necrosis factor alpha blockade is associated with reduction of carotid intima-media thickness in patients with active rheumatoid arthritis. Rheumatology. 2007;46:1111–1115
  59. Hannawi S, Haluska B, Marwick TH, Thomas R. Atherosclerotic disease is increased in recent-onset rheumatoid arthritis: a critical role for inflammation. Arthritis Res Ther. 2007;9:R116
  60. Georgiadis AN, Voulgari PV, Argyropoulou MI, et al. Early treatment reduces the cardiovascular risk factors in newly diagnosed rheumatoid arthritis patients. Semin Arthritis Rheum. 2008;38:13–19
  61. Kaplan MJ, McCune WJ. New evidence for vascular disease in patients with early rheumatoid arthritis. Lancet. 2003;361:1068–1069
  62. Gonzalez-Gay MA, Gonzalez-Juanatey C, Miranda-Filloy JA, et al. Cardiovascular disease in rheumatoid arthritis. Biomed Pharmacother. 2006;60:673–677
  63. Bergholm R, Leirisalo-Repo M, Vehkavaara S, et al. Impaired responsiveness to NO in newly diagnosed patients with rheumatoid arthritis. Arterioscler Throm Vasc Biol. 2002;22:1637–1641
  64. Chung CP, Oeser A, Raggi P, et al. Increased coronary-artery atherosclerosis in rheumatoid arthritis: relationship to disease duration and cardiovascular risk factors. Arthritis Rheum. 2005;52:3045–3053
  65. Symmons DP, Silman AJ. The Norfolk Arthritis Register (NOAR). Clin Exp Rheumatol. 2003;21:S94–S99
  66. Goodson NJ, Wiles NJ, Lunt M, et al. Mortality in early inflammatory polyarthritis: cardiovascular mortality is increased in seropositive patients. Arthritis Rheum. 2002;46:2010–2019
  67. Naz SM, Farragher T, Bunn D, et al. The influence of age at symptom onset and length of followup on mortality in patients with recent-onset inflammatory polyarthritis. Arthritis Rheum. 2008;58:985–989
  68. Farragher TM, Lunt M, Bunn DK, et al. Early functional disability predicts both all-cause and cardiovascular mortality in people with inflammatory polyarthritis: results from the Norfolk Arthritis Register. Ann Rheum Dis. 2007;66:486–492
  69. Young A, Koduri G, Batley M, et al. Mortality in rheumatoid arthritis. Increased in the early course of disease, in ischaemic heart disease and in pulmonary fibrosis. Rheumatology. 2007;46:350–357
  70. Maradit-Kremers H, Crowson CS, Therneau TM, et al. High ten year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients. Arthritis Rheum. 2008;58:2268–2274
  71. Kroot EJ, van Gestel AM, Swinkels HL, et al. Chronic comorbidity in patients with early rheumatoid arthritis: a descriptive study. J Rheumatol. 2001;28:1511–1517
  72. Luqmani R, Hennell SL, Estrach C, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of rheumatoid arthritis (The first 2 years). Rheumatology. 2006;45:1167–1169
  73. Panoulas VF, John H, Kitas GD. Six-step management of hypertension in patients with rheumatoid arthritis. Future Rheumatol. 2008;3:21–35
  74. Georgiadis AN, Papavasiliou EC, Lourida ES, et al. Atherogenic lipid profile is a feature characteristic of patients with early rheumatoid arthritis: effect of early treatment - a prospective, controlled study. Arthritis Res Ther. 2006;8:R82
  75. Farragher T, Goodson N, Naseem H, et al. Association of the HLA-DRB1 gene with premature death, particularly from cardiovascular disease, in patients with rheumatoid arthritis and inflammatory polyarthritis. Arthritis Rheum. 2008;58:359–369
  76. van Halm VP, Nielen MM, Nurmohamed MT, et al. Lipids and inflammation: serial measurements of the lipid profile of blood donors who later developed rheumatoid arthritis. Ann Rheum Dis. 2007;66:184–188
  77. Goodson NJ, Silman AJ, Pattison DJ, et al. Traditional cardiovascular risk factors measured prior to the onset of inflammatory polyarthritis. Rheumatology. 2004;43:731–736
  78. Campbell SC, Moffatt RJ, Stamford BA. Smoking and smoking cessation - the relationship between cardiovascular disease and lipoprotein metabolism: a review. Atherosclerosis. 2008;201:225–235
  79. Pattison DJ, Harrison RA, Symmons DP. The role of diet in susceptibility to rheumatoid arthritis: a systematic review. J Rheumatol. 2004;31:1310–1319
  80. Pattison DJ, Symmons DP, Lunt M, et al. Dietary beta-cryptoxanthin and inflammatory polyarthritis: results from a population-based prospective study. Am J Clin Nutr. 2005;82:451–455
  81. Pattison DJ, Silman AJ, Goodson NJ, et al. Vitamin C and the risk of developing inflammatory polyarthritis: prospective nested case-control study. Ann Rheum Dis. 2004;63:843–847
  82. Pattison DJ, Symmons DP, Lunt M, et al. Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption. Arthritis Rheum. 2004;50:3804–3812
  83. Symmons DP. Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol. 2002;16:707–722
  84. Gonzalez-Juanatey C, Testa A, Garcia-Castelo A, et al. HLA-DRB1 status affects endothelial function in treated patients with rheumatoid arthritis. Am J Med. 2003;114:647–652
  85. Mattey DL, Thomson W, Ollier WE, et al. Association of DRB1 shared epitope genotypes with early mortality in rheumatoid arthritis: results of eighteen years of followup from the early rheumatoid arthritis study. Arthritis Rheum. 2007;56:1408–1416
  86. Arlestig L, Wallberg-Jonsson S, Stegmayr B, Rantapaa-Dahlqvist S. Polymorphism of genes related to cardiovascular disease in patients with rheumatoid arthritis. Clin Exp Rheumatol. 2007;25:866–871
  87. Panoulas VF, Nikas SN, Smith JP, et al. The Lymphotoxin 252A > G polymorphism is common and associates with Myocardial Infarction in patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67:1530–1556
  88. Park Y-B, Ahn C-W, Choi HK, et al. Atherosclerosis in Rheumatoid Arthritis. Morphologic Evidence Obtained by Carotid Ultrasound. Arthritis Rheum. 2002;46:1714–1719

PII: S1521-6942(08)00148-4

doi: 10.1016/j.berh.2008.11.007

Best Practice & Research Clinical Rheumatology
Volume 23, Issue 1 , Pages 71-82 , February 2009

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