Cardiovascular Disease in Rheumatoid Arthritis

Finally, to obtain a historical perspective on why heart disease has come into the spotlight only in recent years, I walked down two offices and asked Ronald Anderson, MD, associate professor in the division of rheumatology, immunology, and allergy at Brigham and Women’s Hospital and Harvard Medical School in Boston, who trained almost everyone in our division, whether heart disease in RA patients was a major concern in the past. To provide me with a point of reference, he said, “In the 1960s and 1970s, patients with RA were often told that there was nothing that could be done for their disease and they should move to a single-floor house.” He also added that high-dose aspirin was a major component of therapy at that time, and this may have been more effective for CVD than for their RA. We have come a long way in terms of treatment options for RA. Although heart disease will always be present, I am hopeful that, in the next decade, excess risk of death from heart disease in RA will also be something that I can say to my trainees used to be seen “back in the day.”

“I shall take the heart,” returned the Tin Woodman, “for brains do not make one happy, and happiness is the best thing in the world.”

Dr. Liao is an instructor in medicine at Harvard Medical School, Brigham and Women’s Hospital in Boston.

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