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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

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

“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.

Is Early, Aggressive RA Treatment Aggressive Enough?

“We know that current treatments are reducing heart attack risk compared to no treatment, but that we are still not eliminating RA-heart disease risks, so this says there is something else going on besides what we are treating.”

Jane Salmon, MD, a senior scientist and Colette Kean Research Chair, Hospital for Special Surgery in New York City, agrees.

“We may not be targeting the right inflammatory mediators or early aggressive treatment may not be aggressive enough,” she says. “There may still be smoldering inflammation.”

Low disease activity doesn’t mean no disease activity, she says.

“We don’t know how low is low enough to affect inflammation in the cells that line the blood vessels,” she says, adding that this inflammation may be present before RA symptoms occur, and a diagnosis is established.

“At this time, all we can say is rigorous attention to other cardiovascular risk factors is critical in RA patients,” she says.

“If you have RA, your chance of having a heart attack is definitely higher than someone who does not have RA,” says Eric Matteson, MD, chair of the department of rheumatology at the Mayo Clinic in Rochester, Minn. “If you smoke, quit; and work to get your general and heart health under control, including cholesterol and blood pressure, if they are elevated,” he says.  “If you have diabetes, get that under control and try to be fit and exercise to what you can tolerate [due to joint pain].”

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