RA Diagnosis Doubles Heart Attack Odds
Diagnosis of Rheumatoid Arthritis Increases Heart Attack Risk Within 10 Years, but Most Treatments Reduce Risk
RA Treatments and Heart Attacks Study
In other research, investigators from the United Kingdom and the Netherlands tried to put in perspective which risk factors for RA patients are most important in predicting heart attack. Among them:
"There has been uncertainty about which factors are most important in the risk of developing heart disease in individuals with RA," says Christopher Edwards, MD, consultant rheumatologist and honorary senior lecturer at Southampton University Hospitals in the U.K., who is presenting the findings.
So his team drew from the large U.K. General Practice Research Data Base, including the records of more than 7 million people. They found 34,364 adults with RA and compared them with 103,089 similar people without the disease, looking at the incidence of heart attack.
They found that those with RA had 6.49 heart attacks per 1,000 people per year, while those without had 2.96 per 1,000 people per year.
The chances of having a heart attack among those with RA, overall, were less in those who took medications for RA. Researchers looked at drugs known as DMARDs (disease-modifying antirheumatic drugs) as well as the steroid prednisolone.
When they looked individually at the medications, they found that all the DMARD medications were protective of the heart but that prednisolone modestly increased the risk. When they took into account risk factors such as high blood pressure, the effects were no longer significant.
Edwards' team also found that cholesterol-lowering medication lowered the rate of heart attack by 25%, but that blood pressure medicines had no significant effect.
And when they compared the effect traditional risk factors had on the heart attacks, they found that they were important, but the risk from having RA was even greater.
The presence of the rheumatoid arthritis itself seems to be the biggest risk factor for heart problems, Edwards says.
RA & Heart Attacks: Second Opinion
The studies provide valuable information for RA patients and doctors, says Eric Matteson, MD, MPH, professor of medicine at Mayo Clinic in Rochester, Minn., who reviewed the studies for WebMD.