Prevalence of traditional modifiable cardiovascular risk factors in patients with rheumatoid arthritis: Comparison with control subjects from the multi-ethnic study of atherosclerosis

Cecilia P. Chung, Jon T. Giles, Michelle Petri, Moyses Szklo, Wendy S Post, Roger S Blumenthal, Allan Gelber, Pamela Ouyang, Nancy S. Jenny, Joan M. Bathon

Research output: Contribution to journalArticle

Abstract

Objective: Despite the recognized risk of accelerated atherosclerosis in patients with rheumatoid arthritis (RA), little is known about cardiovascular risk management in contemporary cohorts of these patients. We tested the hypotheses that major modifiable cardiovascular risk factors were more frequent and rates of treatment, detection, and control were lower in patients with RA than in non-RA controls. Methods: The prevalence of hypertension, diabetes, elevated low-density lipoprotein (LDL) cholesterol, elevated body mass index, smoking, moderate-high 10-year cardiovascular risk and the rates of underdiagnosis, therapeutic treatment, and recommended management were compared in 197 RA patients and 274 frequency-matched control subjects, and their associations with clinical characteristics were examined. Results: Eighty percent of RA patients and 81% of control subjects had at least 1 modifiable traditional cardiovascular risk factor. Hypertension was more prevalent in the RA group (57%) than in controls [42%, P = 0.001]. There were no statistically significant differences in the frequency of diabetes, elevated body mass index, smoking, intermediate-high 10-year coronary heart disease risk, or elevated LDL in patients with RA versus controls. Rates of newly identified diabetes, hypertension, and hyperlipidemia were similar in RA patients versus controls. Rates of therapeutic interventions were low in both groups but their use was associated with well-controlled blood pressure (OR = 4.55, 95% CI: 1.70, 12.19) and lipid levels (OR = 9.90, 95% CI: 3.30, 29.67). Conclusions: Hypertension is more common in RA than in controls. Other traditional cardiovascular risk factors are highly prevalent, underdiagnosed, and poorly controlled in patients with RA, as well as controls.

Original languageEnglish (US)
Pages (from-to)535-544
Number of pages10
JournalSeminars in Arthritis and Rheumatism
Volume41
Issue number4
DOIs
StatePublished - Feb 2012

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Rheumatoid Arthritis
Atherosclerosis
Hypertension
Body Mass Index
Smoking
Risk Management
Therapeutics
Hyperlipidemias
LDL Lipoproteins
LDL Cholesterol
Arthritis
Coronary Disease
Blood Pressure
Lipids

Keywords

  • Cardiovascular risk
  • Epidemiology
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine

Cite this

@article{e25a717ea52748f89c7f7abb4918775b,
title = "Prevalence of traditional modifiable cardiovascular risk factors in patients with rheumatoid arthritis: Comparison with control subjects from the multi-ethnic study of atherosclerosis",
abstract = "Objective: Despite the recognized risk of accelerated atherosclerosis in patients with rheumatoid arthritis (RA), little is known about cardiovascular risk management in contemporary cohorts of these patients. We tested the hypotheses that major modifiable cardiovascular risk factors were more frequent and rates of treatment, detection, and control were lower in patients with RA than in non-RA controls. Methods: The prevalence of hypertension, diabetes, elevated low-density lipoprotein (LDL) cholesterol, elevated body mass index, smoking, moderate-high 10-year cardiovascular risk and the rates of underdiagnosis, therapeutic treatment, and recommended management were compared in 197 RA patients and 274 frequency-matched control subjects, and their associations with clinical characteristics were examined. Results: Eighty percent of RA patients and 81{\%} of control subjects had at least 1 modifiable traditional cardiovascular risk factor. Hypertension was more prevalent in the RA group (57{\%}) than in controls [42{\%}, P = 0.001]. There were no statistically significant differences in the frequency of diabetes, elevated body mass index, smoking, intermediate-high 10-year coronary heart disease risk, or elevated LDL in patients with RA versus controls. Rates of newly identified diabetes, hypertension, and hyperlipidemia were similar in RA patients versus controls. Rates of therapeutic interventions were low in both groups but their use was associated with well-controlled blood pressure (OR = 4.55, 95{\%} CI: 1.70, 12.19) and lipid levels (OR = 9.90, 95{\%} CI: 3.30, 29.67). Conclusions: Hypertension is more common in RA than in controls. Other traditional cardiovascular risk factors are highly prevalent, underdiagnosed, and poorly controlled in patients with RA, as well as controls.",
keywords = "Cardiovascular risk, Epidemiology, Rheumatoid arthritis",
author = "Chung, {Cecilia P.} and Giles, {Jon T.} and Michelle Petri and Moyses Szklo and Post, {Wendy S} and Blumenthal, {Roger S} and Allan Gelber and Pamela Ouyang and Jenny, {Nancy S.} and Bathon, {Joan M.}",
year = "2012",
month = "2",
doi = "10.1016/j.semarthrit.2011.07.004",
language = "English (US)",
volume = "41",
pages = "535--544",
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}

TY - JOUR

T1 - Prevalence of traditional modifiable cardiovascular risk factors in patients with rheumatoid arthritis

T2 - Comparison with control subjects from the multi-ethnic study of atherosclerosis

AU - Chung, Cecilia P.

AU - Giles, Jon T.

AU - Petri, Michelle

AU - Szklo, Moyses

AU - Post, Wendy S

AU - Blumenthal, Roger S

AU - Gelber, Allan

AU - Ouyang, Pamela

AU - Jenny, Nancy S.

AU - Bathon, Joan M.

PY - 2012/2

Y1 - 2012/2

N2 - Objective: Despite the recognized risk of accelerated atherosclerosis in patients with rheumatoid arthritis (RA), little is known about cardiovascular risk management in contemporary cohorts of these patients. We tested the hypotheses that major modifiable cardiovascular risk factors were more frequent and rates of treatment, detection, and control were lower in patients with RA than in non-RA controls. Methods: The prevalence of hypertension, diabetes, elevated low-density lipoprotein (LDL) cholesterol, elevated body mass index, smoking, moderate-high 10-year cardiovascular risk and the rates of underdiagnosis, therapeutic treatment, and recommended management were compared in 197 RA patients and 274 frequency-matched control subjects, and their associations with clinical characteristics were examined. Results: Eighty percent of RA patients and 81% of control subjects had at least 1 modifiable traditional cardiovascular risk factor. Hypertension was more prevalent in the RA group (57%) than in controls [42%, P = 0.001]. There were no statistically significant differences in the frequency of diabetes, elevated body mass index, smoking, intermediate-high 10-year coronary heart disease risk, or elevated LDL in patients with RA versus controls. Rates of newly identified diabetes, hypertension, and hyperlipidemia were similar in RA patients versus controls. Rates of therapeutic interventions were low in both groups but their use was associated with well-controlled blood pressure (OR = 4.55, 95% CI: 1.70, 12.19) and lipid levels (OR = 9.90, 95% CI: 3.30, 29.67). Conclusions: Hypertension is more common in RA than in controls. Other traditional cardiovascular risk factors are highly prevalent, underdiagnosed, and poorly controlled in patients with RA, as well as controls.

AB - Objective: Despite the recognized risk of accelerated atherosclerosis in patients with rheumatoid arthritis (RA), little is known about cardiovascular risk management in contemporary cohorts of these patients. We tested the hypotheses that major modifiable cardiovascular risk factors were more frequent and rates of treatment, detection, and control were lower in patients with RA than in non-RA controls. Methods: The prevalence of hypertension, diabetes, elevated low-density lipoprotein (LDL) cholesterol, elevated body mass index, smoking, moderate-high 10-year cardiovascular risk and the rates of underdiagnosis, therapeutic treatment, and recommended management were compared in 197 RA patients and 274 frequency-matched control subjects, and their associations with clinical characteristics were examined. Results: Eighty percent of RA patients and 81% of control subjects had at least 1 modifiable traditional cardiovascular risk factor. Hypertension was more prevalent in the RA group (57%) than in controls [42%, P = 0.001]. There were no statistically significant differences in the frequency of diabetes, elevated body mass index, smoking, intermediate-high 10-year coronary heart disease risk, or elevated LDL in patients with RA versus controls. Rates of newly identified diabetes, hypertension, and hyperlipidemia were similar in RA patients versus controls. Rates of therapeutic interventions were low in both groups but their use was associated with well-controlled blood pressure (OR = 4.55, 95% CI: 1.70, 12.19) and lipid levels (OR = 9.90, 95% CI: 3.30, 29.67). Conclusions: Hypertension is more common in RA than in controls. Other traditional cardiovascular risk factors are highly prevalent, underdiagnosed, and poorly controlled in patients with RA, as well as controls.

KW - Cardiovascular risk

KW - Epidemiology

KW - Rheumatoid arthritis

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U2 - 10.1016/j.semarthrit.2011.07.004

DO - 10.1016/j.semarthrit.2011.07.004

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JO - Seminars in Arthritis and Rheumatism

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