PHILADELPHIA—Risk of cardiovascular disease is about 50% higher for people with rheumatoid arthritis (RA) than the general population, and is also increased as for those with other autoimmune diseases, such as systemic lupus erythematosus.
Naveed Sattar, MD, professor of metabolic medicine at the University of Glasgow, Scotland, said that the risk for vascular disease in patients with rheumatic disease accrues early. In his presentation at the ACR Clinical Research Conference here at the 2009 ACR/ARHP Annual Scientific Meeting, Dr. Sattar said there are compelling reasons to screen for cardiovascular risk in patients older than age 40 who have rheumatic disease.
“These patients are more likely to die before they get to the hospital if they have a myocardial infarction,” he said. “They are less likely to be symptomatic and are more likely to have ischemic heart disease, receive less treatment for hypertension, and develop more congestive heart failure.” If these patients survive the myocardial infarction and make it to the hospital, they have a 30-day mortality rate of about 50% to 90%, he said.
In an overview of how inflammation leads to cardiovascular disease, Muredach Reilly, MBBCh, assistant professor of medicine and pharmacology in the cardiovascular medicine division at the Hospital of the University of Pennsylvania in Philadelphia, said that changes in signaling via mechanical transduction and hypercholesterolemia induce endothelial cell dysfunction that then promotes inflammation and fatty streak formation.