Doctors have long known that heart disease is more common in people who have inflammatory conditions such as rheumatoid …. Generally, patients with rheumatoid arthritis RA have higher levels of inflammation in their bodies, which can affect …. Women who have diabetes and rheumatoid arthritis high cholesteral idiopathic arthritis JIA — an umbrella term for several types of arthritis that develop in c…. Among the serious complications people with rheumatoid arthritis RA experience, cardiovascular disease heads the list.
Having RA doubles the risk of most heart problems, including heart attack, stroke and atherosclerosis — the buildup of fat, cholesterol and cellular diabetes and rheumatoid arthritis high cholesteral plaque on blood vessel walls. Solomon, MD, a professor at Harvard Medical School in Boston and a leading researcher on cardiovascular disease and RA, says the inflammatory processes in RA and heart disease are very similar.
In RA, diabetes and rheumatoid arthritis high cholesteral, inflammation attacks the synovium — the thin layer of tissue that lines your joints — but it can move to other organs, including the heart.
One of the possible victims is the endothelium, the innermost layer of blood vessels. Inflammation causes damage to the blood vessel lining, and plaque builds up. This fatty deposit narrows arteries, raising blood pressure and reducing diabetes and diets flow of blood to your heart and other organs. In a study in Nature Reviews RheumatologyBritish investigators reported that people with RA are more likely to have atherosclerosis than the general population and that they develop it at a faster rate.
Plaque is also more brittle and prone to rupture in RA, and more likely to cause a heart attack or stroke.
In fact, the risk of ischemic stroke, diabetes and rheumatoid arthritis high cholesteral, resulting from a clot in an artery supplying blood to the brain, is nearly doubled in people with RA. Atherosclerosis starts early in the course of RA — often before there are joint symptoms — and progresses rapidly after RA is diagnosed. It affects veins, too, increasing the risk of deep vein thrombosis DVT and pulmonary embolism — blood clots in the legs or lungs. A Mayo Clinic study found a three-time greater risk of DVT in people with RA and a more than four-times greater risk of life-threatening pulmonary embolism.
Some research, including a Mayo Clinic study published in BioMed Diabetes and rheumatoid arthritis high cholesteral Internationalsuggests that people with RA have a significantly increased risk of atrial fibrillation AF — an irregular heartbeat that can increase stroke risk fivefold. The study also reported an association between diastolic dysfunction, an abnormality in how the heart fills with blood, and AF, and that patients with RA are known to have increased prevalence of diastolic dysfunction.
Inflammation of the two-layered sac that surrounds the heart known as the pericardium is also more common in patients with RA.
The inflamed sacs rub against each other, causing sharp, intense chest pain. Making sense of how inflammation and other risk factors influence RA-related heart disease will help doctors identify and treat high-risk patients early, before they develop symptoms.
In the May issue of Arthritis and Rheumatologydiabetes and rheumatoid arthritis high cholesteral, he and his colleagues published an expanded and validated risk assessment specifically for RA. In addition to traditional cardiovascular risk factors, they also included RA disease activity, disability, prednisone use and years with RA. The researchers found the expanded assessment improved classification of risk compared with traditional risk assessments.
Although progress is being made, preventing or reducing heart disease risk in people with RA remains challenging, in part because there are no specific guidelines or recommendations, Dr.
That would include people with more severe disease, disease that is difficult to control with typical medications and those who already have multiple risk factors, diabetes and rheumatoid arthritis high cholesteral.
Davis says no one approach is right for every patient, preventive strategies generally include treating RA aggressively to bring inflammation under tight control; reducing use of medications that damage the heart; and supporting patients in their efforts to control lifestyle factors known to play a role in heart disease.
Lifestyle changes that help to reduce your risk of heart disease, include being physically activity, eating a healthy diet and working with your doctors to minimize medication side effects.
And most of all, if you smoke, stop. Arthritis Friend or Foe? How Much Is Enough?