Autoimmune Inflammation Increases Risk of Heart Disease

“But if we find this, can we do something different for the patient? I certainly talk to these patients about the risks, and we talk about nonpharmacological ways to improve their endothelial function: diet, exercise and weight loss,” she said. Statins can improve both inflammation and cholesterol levels in these patients, “but should they be used routinely in RA patients? Obviously, the guidelines don’t say so.”¹²

Treat Inflammation Aggressively

Long-term corticosteroids have a negative effect on carotid artery thickness, said Dr. Mankad.¹³ “If you’re using bursts of steroids here and there, maybe it’s OK because you’re driving down the inflammation. But if you’re using them chronically, lots of bad things can happen.” TNF inhibitors appear to have a slightly better effect on CVD risk than non-biologic DMARDs, she said.¹⁴

Rheumatologists should watch for clues that suggest a patient needs more extensive cardiovascular screening, she said. “Always have a high index of suspicion and, depending on the patient, watch for the symptoms and signs of heart disease.”

Susan Bernstein is a freelance journalist based in Atlanta.

References

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