Patients with rheumatoid arthritis are intimately familiar with swollen, throbbing joints. Less well known is their increased risk of developing cardiovascular disease, a disease of the heart and blood vessels that currently affects over 70 million Americans. The chief cause of cardiovascular disease is atherosclerosis, the development of plaques that harden blood-vessel walls, making them less flexible. Since inflammation contributes to the worsening of both atherosclerosis and rheumatoid arthritis, researchers investigated whether rheumatoid arthritis hastens the progression of cardiovascular disease.

What the researchers wanted to know: Does rheumatoid arthritis cause cardiovascular disease to progress faster?

What they did: Researchers compared the medical histories of 75 patients with rheumatoid arthritis who were newly diagnosed with coronary artery disease (a type of cardiovascular disease) with the histories of 128 patients who had coronary artery disease but did not have rheumatoid arthritis. They documented the patients' cardiovascular disease risk factors and recorded whether the patients had certain changes in their health, such as a heart attack or surgery to repair the heart's blood vessels. Researchers also looked for evidence of the plaques that characterize atherosclerosis.

What they found: Patients newly diagnosed with coronary artery disease who also had rheumatoid arthritis had more blocked heart vessels–and thus more advanced disease–than those without rheumatoid arthritis. While both groups had similar rates of cardiovascular events, such as a heart attack, those with rheumatoid arthritis suffered more deaths due to cardiovascular causes, though a bigger study may be needed to confirm those results. Researchers posited that a certain type of inflammatory cell involved in both rheumatoid arthritis and coronary artery disease might play a role in faster progression of atherosclerosis in patients with both diseases.

What it means to you: If you have rheumatoid arthritis, you should be extra vigilant about cardiovascular risk factors such as high cholesterol, high blood pressure, diabetes, obesity, and smoking. You should consult your primary care provider, rheumatologist, or cardiologist with any questions or concerns about how to decrease your risk, either by changing your behavior or by taking medication.

Caveats: The authors were unable to account for certain details that may affect a patient's cardiovascular disease risk-factor profile, such as family history and how much a person smoked.

Find out more: The Arthritis Foundation has a page with information on the connection between rheumatoid arthritis and atherosclerosis.

The National Institutes of Health has a page on prevention of cardiovascular disease.

Read the article: Warrington, K., et al. "Rheumatoid Arthritis Is an Independent Risk Factor for Multi-Vessel Coronary Artery Disease: A Case Control Study." Arthritis Research & Therapy. June 29, 2005, Vol. 7, No. 5, pp. R984-R991.

Abstract online: http://arthritis-research.com