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Heart Attack Risk Quickly Follows RA Diagnosis

Heart Attack Risk Goes Up 60% Just 1 Year After Diagnosis of Rheumatoid Arthritis, Study Finds
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Heart Risk Occurs Sooner After RA Diagnosis Than Thought

“We have long known there is an increased cardiovascular risk in patients with RA and other inflammatory diseases, but the new perspective is how this risk quickly occurs,” says David Pisetsky, MD, chief of rheumatology at Duke University Medical Center in Durham, N.C.

“Most of us would have thought that it would have taken longer for this risk to be seen, but this study says the risk increases almost from the time of diagnosis,” he says.

This timing is important in terms of understanding why this increased cardiovascular risk occurs, he says.

“There are conventional heart disease risk factors and there are others that people don’t fully understand, such as the contributors of inflammatory mediators to heart disease,” he says. People with RA have active immune systems, and that promotes inflammation in the blood vessels as well as in the joints, which may affect the heart, he says.

Efforts Aimed at the Prevention and Awareness of Heart Disease Risk Factors in RA

Until researchers sort out the all the whys, people with RA need to be aware of the symptoms of heart attack and heart disease. “It can be clear-cut like crushing chest pain, but people with RA have pain and it is easy to say ‘my chest or shoulder hurts because of RA,’ but in fact it may be related to heart disease,” Pisetsky says.  Women, especially, experience more nontraditional heart attack symptoms, such as dizziness, nausea, and fatigue. Women are also disproportionately affected by RA.

“Get the RA under control and address any of the modifiable risk factors for heart disease,” he says. “People with RA shouldn’t smoke and they should lose weight, if they are overweight, and exercise.”

Martin J. Bergman, MD, the chief of the division of rheumatology at Taylor Hospital in Ridley Park, Pa., and a clinical associate professor at Drexel University College of Medicine in Philadelphia says, “The heart attacks are occurring much earlier than we thought. We always knew about this risk, but we thought it was down the line.”

“Despite aggressive therapies, people with RA still have an increased risk of heart attacks, which is somewhat dismaying,” he says.

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