Rheumatoid arthritis and risk of cardiovascular disease

• Published in: Cardiovascular Journal of Africa Vol. 29; no. 5; pp. 317 - 321
• Main Authors: Ker, James A., Meyer, Pieter W.A., Ally, Mahmood T.M., Anderson, Ronald
• Format: Journal Article
• Language: English
• Published: South Africa Clinics Cardive Publishing 01.09.2018
• Subjects: Antirheumatic Agents - adverse effects; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - epidemiology; Arthritis, Rheumatoid - mortality; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Cardiovascular risk; Cause of Death; Chronic inflammation; Comorbidity; Disability Evaluation; Effects of drug treatment; Humans; Prevalence; Prognosis; Review; Rheumatoid arthritis; Risk Assessment; Risk Factors; Smoking - adverse effects; Smoking - epidemiology; Tobacco usage; Tobacco, Smokeless - adverse effects
• ISSN: 1995-1892; 1680-0745
• DOI: 10.5830/CVJA-2018-018

In developing countries, rheumatoid arthritis (RA) remains a seriously under-prioritised disease, particularly among the underprivileged, often resulting in presentation of patients late in the course of their disease, further complicated by limited therapeutic options and inconsistent follow up. The consequences are often severe with irreversible disability, increased frequency of co-morbidities, especially cardiovascular disease (CVD), and higher mortality rates, relative to developed countries. Despite addressing traditional cardiovascular risk factors, the impact of subclinical or ‘residual’ inflammation from uncontrolled RA needs to be considered. This narrative review explores the prevalence and pathogenesis of CVD in RA, including the impact of tobacco use. It discusses pitfalls in the risk assessment of CVD in patients with RA, and the effect of disease-modifying anti-rheumatic therapy on cardiovascular co-morbidity.