Cardiovascular Risk Factors Insufficiently Treated in PsA and RA

Jan 23, 2017

Patients with inflammatory arthritis are being treated for cardiovascular risk factors at rates similar to that of the general population, even though their risk is higher, study shows.

Researchers have confirmed an increased prevalence and incidence of modifiable cardiovascular risk factors in patients with inflammatory arthritis, but interestingly, they show that these patients are being treated for cardiovascular risk factors at similar rates to that of the general population. 

The study appears in the Dec. 27 online issue of Arthritis Care & Research.

The study is based on a review of data from the Health Improvement Network, a medical record database from the United Kingdom. Records of adult patients (18-89 years old) who were treated between 1994 and 2014.

Led by Alexis Ogdie, M.D., of the University of Pennsylvania, researchers compared the prevalence of hypertension, hyperlipidemia, obesity and diabetes mellitus among patients with psoriatic arthritis and rheumatoid arthritis as compared to the general population. Then they compared the prescribed treatments for patients who were diagnosed with hypertension, hyperlipidemia and diabetes mellitus.

They found a significantly higher prevalence of all cardiovascular disease risk factors among psoriatic arthritis patients. While rheumatoid arthritis patients experienced increased risk factors for only diabetes and obesity. Both groups of patients had a higher incidence of of hypertension, hyperlipidemia and diabetes. Approximately 85 percent, 65 percent and 45 percent of patients received prescriptions for hypertension, hyperlipidemia and diabetes respectively.

Prior studies have shown that patients with psoriatic arthritis and rheumatoid arthritis have a higher risk of cardiovascular disease as compared to patients without rheumatoid arthritis or psoriatic arthritis. In particular, patients with psoriatic arthritis have systemic inflammation that increases their risk for strokes, heart attacks and cardiovascular death. However, few studies have been conducted from a population-based perspective.

Rheumatoid arthritis or psoriatic arthritis patients were more likely to receive anti-hypertensive treatment, while rheumatoid arthritis patients were more likely to receive lipid-lowering therapy as compared to controls.  [[{"type":"media","view_mode":"media_crop","fid":"56013","attributes":{"alt":"(Increased Cardiovascular Risk ©Arka38/Shutterstock.com)","class":"media-image media-image-right","id":"media_crop_96242073259","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"7030","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; float: right;","title":"(Increased Cardiovascular Risk ©Arka38/Shutterstock.com)","typeof":"foaf:Image"}}]]

There has been little research on the benefits of aggressive treatment of cardiovascular disease risk factors in patients with inflammatory arthritis. Inflammatory arthritis was not included in the 2013 cardiovascular risk calculator published by the American College of Cardiology and the American Heart Association, due to the lack of sufficient data, the researchers wrote.

Still, physicians should discuss cardiovascular risk with their patients, researchers wrote.

“Rheumatologists have the unique ability to address this issue in the context of their long-term relationships with their patients. Previous studies have suggested that in the U.S., patients with rheumatoid arthritis often view their rheumatologists as their main providers. Although there are time constraints during each office visit, more effective management of cardiovascular risk factors has the potential to significantly influence the morbidity and mortality of our patient population,” researchers wrote.

 

Disclosures:

This research was supported in part by the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases and the Rheumatology Research Foundation in the United States.

 

References:

Kashif Jafri, Christie M. Bartels, Daniel Shin, et al. “Incidence and Management of Cardiovascular Risk Factors in Psoriatic Arthritis and Rheumatoid Arthritis: A Population-Based Study,” Arthritis Care & Research. Published online November 28, 2016. DOI: 10.1002/acr.23094

x