Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the joints, causing stiffness, swelling, and pain. RA is also associated with increased risk of cardiovascular disease (CVD), which is the leading cause of death worldwide.

According to several studies, individuals with RA are at a higher risk of developing CVD compared to the general population.

The Link between RA and CVD

RA is an autoimmune disease that results in the immune system attacking the joints, leading to inflammation and destruction of cartilage and bone. However, inflammation in RA can also affect other organs, including the heart and blood vessels.

Chronic inflammation can lead to the formation of plaques in the arteries, which can narrow the passage for blood to flow through. This can lead to a variety of CVD symptoms, such as coronary artery disease, myocardial infarction, and stroke.

Aside from inflammation, several other factors contribute to the increased risk of CVD in individuals with RA. These include:.

Traditional cardiovascular risk factors, such as smoking, hypertension, diabetes, and dyslipidemia, are more prevalent in individuals with RA.
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) for the management of RA can have negative effects on cardiovascular health.
Physical inactivity resulting from joint pain and stiffness can lead to a sedentary lifestyle and increased risk of CVD.

Prevention and Management of CVD in RA

Preventing and managing CVD in individuals with RA requires a multidisciplinary approach involving rheumatologists, cardiologists, and primary care physicians.

Lifestyle modifications and pharmacologic interventions can help address traditional cardiovascular risk factors and reduce the risk of CVD. These interventions include:.

Quitting smoking and reducing exposure to environmental tobacco smoke.
Managing hypertension, diabetes, and dyslipidemia through lifestyle modifications and/or medication.
Encouraging physical activity through structured exercise programs and physical therapy.
Reducing the use of NSAIDs and using DMARDs that have less cardiovascular toxicity.

CVD Risk Assessment in RA

Individuals with RA should undergo regular cardiovascular risk assessments to monitor for the development of CVD. Several tools can be used to calculate cardiovascular risk in individuals with RA, such as the Framingham Risk Score and the QRISK3 Score.

These tools take into account traditional cardiovascular risk factors, plus the presence of RA and its specific disease activity markers.

The Importance of Early Detection and Treatment

Early detection and treatment of RA and its associated comorbidities can help reduce the risk of CVD.

Regular monitoring for joint inflammation and radiographic progression can identify individuals who may benefit from advanced treatment, such as biologic agents. Biologics have been shown to reduce inflammation in the joints and also have beneficial effects on cardiovascular health, reducing the risk of CVD in individuals with RA.

Conclusion

The link between RA and CVD underscores the importance of identifying and managing cardiovascular risk in individuals with RA.

A multidisciplinary approach that addresses traditional cardiovascular risk factors, encourages physical activity, and uses medications with less cardiovascular toxicity can reduce the risk of CVD in these patients. Regular cardiovascular risk assessments and early detection and treatment of RA can help minimize the risk of CVD and improve overall health outcomes.