Rheumatoid Arthritis Doubles Heart Risk
Question Remains if RA Treatment Can Decrease Risk
Feb. 18, 2003 -- Women with rheumatoid arthritis are twice as likely to have heart attacks, say researchers. And having arthritis for 10 years or more triples the risk.
The findings add to the growing evidence that inflammation, which is a key component of rheumatoid arthritis, is critical in the development of heart disease. It is now widely believed that hardening of the arteries -- the buildup of fatty deposits in blood vessels that leads to heart attacks -- is largely caused by inflammation.
"It looks like inflammation is becoming more of a common denominator in [heart] disease, and it is not much of a stretch to think that rheumatoid arthritis and heart disease might be related," cardiologist Gerald Fletcher, MD, tells WebMD. "People with rheumatoid problems seem to have more heart problems than others. This link is certainly intriguing." Fletcher is a national spokesman for the American Heart Association and is director of preventive cardiology at the Mayo Clinic in Jacksonville, Fla.
Roughly 2 million Americans -- three-quarters of them women -- have rheumatoid arthritis. In the newly reported study, researchers from Harvard University's Brigham and Women's Hospital examined the association between the autoimmune disorder and heart disease, which is already the leading cause of death among American women.
More than 114,000 women in the ongoing Nurses Health Study were evaluated for a history of heart attack, stroke, and rheumatoid arthritis. The researchers were able to control for known heart disease risk factors, such as high blood pressure and cholesterol, because the women have been closely followed for two decades.
Researchers found a doubling in heart attack risk among the women with arthritis, but the link between arthritis and stroke was not significant. The findings are reported in the March issue of Circulation: Journal of the American Heart Association.
"We really need to be looking at rheumatoid arthritis patients as folks who are at high risk for having future heart attacks," lead investigator Daniel Solomon, MD, tells WebMD. "These patients need to be counseled about how to lower their risk through lifestyle."
Solomon says it may turn out that early treatment of rheumatoid arthritis with anti-inflammatory drugs is protective against heart disease. Arthritis patients may also benefit, he says, from heart-protecting drugs like cholesterol-lowering statins and aspirin.
"Our study illustrates the importance of considering more aggressive cardiac preventive measures in arthritic patients," he says. This study indicates that it would be useful to examine how medications and lifestyle changes may be able to reduce the risk of heart disease in this population, Solomon adds.