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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 continued...

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.

The first study, he says, confirms that "it is the disease itself which is a major risk factor for getting heart attacks."

The research also suggests that the traditional risk factors for heart disease are very important for people with RA, he says, as well as the increased risk from having RA.

The information about the RA drugs is mostly good, he adds. "If you have this disease and you aren't taking these drugs, your chances of getting a heart attack are much higher and you can reduce that risk by managing your rheumatoid arthritis," he says. "You don't bring it back to the baseline risk, but the good news is you can reduce the risk by taking the medications that control the disease."

The information about prednisolone boosting risk is not surprising, Matteson says, because the drug boosts blood fats. The increase in risk, he says, isn't as much as the traditional risk factors, according to the study findings. Still, he says, prednisolone is useful for managing the disease when needed.

RA & Heart Attack: Advice

The message is simple for RA patients and physicians hoping to reduce heart attack risk, Edwards tells WebMD. It's crucial to treat both the disease symptoms and the heart attack risk factors. The attention needs to be focused not just on the joints, but also on the blood vessels.


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