Therapy insight

Managing cardiovascular risk in patients with rheumatoid arthritis

Jon T. Giles, Wendy S Post, Roger S Blumenthal, Joan M. Bathon

Research output: Contribution to journalArticle

Abstract

Chronic low-grade inflammation was recognized during the past decade as an important risk factor for the development of atherosclerosis and, more recently, for the development of heart failure. Patients with rheumatoid arthritis (RA) are at increased risk of morbidity and mortality from ischemic cardiovascular events and heart failure. Epidemiologic and clinical studies indicate that RA is an independent risk factor for cardiovascular disease, which suggests that chronic exposure to high levels of inflammatory mediators contributes to this enhanced risk. The relative contribution of conventional risk factors to the acceleration of cardiovascular disease does not seem to be increased in patients with RA compared with control populations. Nonetheless, some preclinical laboratory measures of risk factors (e.g. insulin sensitivity) are adversely modulated in the context of the highly inflammatory rheumatoid microenvironment. Discerning the net effect of RA therapies on cardiovascular disease is also challenging because, theoretically, their biologic effects could either promote or attenuate atherosclerosis and ventricular dysfunction; however, available data suggest a beneficial effect on cardiovascular morbidity and mortality in patients with RA. This review provides an overview of the potential influence of RA and its treatment on the development and progression of cardiovascular disease, and outlines some preliminary recommendations for prevention and management of this complication in patients with RA.

Original languageEnglish (US)
Pages (from-to)320-329
Number of pages10
JournalNature Clinical Practice Rheumatology
Volume2
Issue number6
DOIs
StatePublished - Jun 2006

Fingerprint

Rheumatoid Arthritis
Cardiovascular Diseases
Therapeutics
Atherosclerosis
Heart Failure
Morbidity
Ventricular Dysfunction
Mortality
Insulin Resistance
Epidemiologic Studies
Inflammation
Population

Keywords

  • Atherosclerosis
  • Cardiovascular disease
  • Cytokines
  • Pharmacotheraphy
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Therapy insight : Managing cardiovascular risk in patients with rheumatoid arthritis. / Giles, Jon T.; Post, Wendy S; Blumenthal, Roger S; Bathon, Joan M.

In: Nature Clinical Practice Rheumatology, Vol. 2, No. 6, 06.2006, p. 320-329.

Research output: Contribution to journalArticle

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