Standard heart disease risk tools underrate danger in rheumatoid arthritis
Heart disease risk assessment tools commonly used by physicians often underestimate the cardiovascular disease danger faced by rheumatoid arthritis patients, a Mayo Clinic study has found. Inflammation plays a key role in putting those with rheumatoid arthritis in greater jeopardy for heart disease, yet many cardiovascular disease risk assessment methods do not factor it in, the researchers note. More work is needed to figure out what drives heart disease in rheumatoid arthritis patients, and more accurate tools to assess that risk should be developed, the authors say. The study is published online in the American Journal of Cardiology.
In rheumatoid arthritis, the immune system attacks tissues, inflaming joints. It can also affect other parts of the body. Rheumatoid arthritis patients have a higher risk of early death than the general population, and previous research suggests cardiovascular disease is the main reason. The Mayo study gauged the accuracy of two commonly used tools for assessing heart disease danger the Framingham and Reynolds risk scores and found they substantially underrated cardiovascular disease danger in women and men with rheumatoid arthritis, particularly in older patients and people who test positive for rheumatoid factors, proteins produced by the immune system and often associated with rheumatoid arthritis.
"This study emphasizes that patients with rheumatoid arthritis are at higher risk for heart disease, and that conventional predictors of risk are not adequate for estimating this risk. Physicians caring for patients with rheumatoid arthritis should be aware of this heightened risk even when conventional risk factors seem to indicate no increased risk, and consider measures to assess and lower CV risk in these patients," says co-author Eric Matteson, M.D., chairman of Mayo Clinic's rheumatology division.
Among those studied were 525 patients over 30 who were diagnosed with rheumatoid arthritis between 1988 and 2007 and had no previous history of cardiovascular disease. The study used medical records from the National Institutes of Health-funded Rochester Epidemiology Project, whose resources make Olmsted County, Minn., one of the few places in the world where researchers can examine medical data on virtually everyone in a defined geographic population to find the true frequency of certain conditions and the success of treatments.
The patients' 10-year risk of developing cardiovascular disease was measured using the Framingham and Reynolds risk scores. The mean follow-up period was 8.4 years; 84 patients developed cardiovascular disease during that time. The observed heart disease risk turned out to be twice as high among women and 65 percent higher in men than the Framingham risk score predicted, and the Reynolds tool had similar shortcomings, researchers found. Patients 75 and older proved to be three times more at risk than the Framingham score indicated. Patients with positive rheumatoid factor also had more heart disease events than the risk scores predicted.
"Ongoing research is attempting to determine how inflammation leads to increased cardiovascular risk in rheumatoid arthritis, and what treatments for rheumatoid arthritis might reduce this risk," Dr. Matteson says. "Further work must also evaluate just how patients with rheumatoid arthritis should be managed to detect and reduce their risk for cardiovascular disease."
Journal reference: American Journal of Cardiology
Provided by Mayo Clinic
- Rheumatoid arthritis linked to irregular heart rhythm Mar 08, 2012 | not rated yet | 0
- Young women with rheumatoid arthritis at more risk for broken bones Nov 06, 2011 | not rated yet | 0
- Lower GI problems plague many with rheumatoid arthritis Apr 03, 2012 | not rated yet | 0
- Obesity epidemic fueling rise in rheumatoid arthritis among women Apr 25, 2012 | not rated yet | 0
- Arthritis sufferers at increased risk of heart disease Aug 15, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
the rudyak-krasnolutski effective potencial
25 minutes ago Hi ... anyone now how to calculate or the formula of the rudyak-krasnolutski EFFECTIVE potencial ? the effective potencial includes the angular...
Normal force for a lever model
1 hour ago My model is a lever on a table top. One arm is horizontal on the table, while the other arm is raised at an angle alpha. I'm assuming the weight of...
gravity is std. therefore can we rate a 'mass at height' by watts?
7 hours ago For example.... wind turbines are primarily listed by their wattage (1.5MW etc.) Presumably their output is varied according to rotational speed, so...
Calculating on-axis elements of a solenoid
19 hours ago I wanted to mention that this solenoid has many winds over many layers. The thickness of the windings is 2.4 inches coming off of the engineering...
latitude & longitude & air pressure
20 hours ago Hi there, I have a peculiar question. Imagine that you are in a earth position, obtained by google, that gives you the latitude and longitude....
Differences of Classical Mechanics when learned with Calc vs algebra?
23 hours ago what are the differences? Every example I find usually has a derivative or integral or some kind of calculus defined concept that seems to make it...
- More from Physics Forums - Classical Physics
More news stories
UCLA researchers examining outcomes for advanced heart-failure patients over the past two decades have found that, coinciding with the increased availability and use of new therapies, overall mortality has decreased and sudden ...
Cardiology 52 minutes ago | not rated yet | 0
22 May 2013, Paris, France: The Lotus Valve, a second-generation transcatheter aortic valve implantation (TAVI) device, was successfully implanted in all of the first 60 patients in results from REPRISE II reported at EuroPCR ...
Cardiology 5 hours ago | not rated yet | 0
Costs to treat stroke are projected to more than double and the number of people having strokes may increase 20 percent by 2030, according to the American Heart Association/American Stroke Association.
Cardiology May 22, 2013 | not rated yet | 0
Blood thinners are the preferred treatment option to prevent heart attacks, blood clots and stroke, but they are not without risk, and not just because of their side effects. These high-risk drugs, known as anticoagulants, ...
Cardiology May 22, 2013 | not rated yet | 0
Results from a large observational study reported at EuroPCR 2013 today question whether bivalirudin is superior to heparin in the absence of GPIIb/IIIa blockade, showing similar 30-day mortality in patients with non-ST segment ...
Cardiology May 22, 2013 | 5 / 5 (1) | 0
Ethnic background plays a surprisingly large role in how diabetes develops on a cellular level, according to two new studies led by researchers at the Stanford University School of Medicine.
25 minutes ago | not rated yet | 0 |
Cinnamon: Can the red-brown spice with the unmistakable fragrance and variety of uses offer an important benefit? The common baking spice might hold the key to delaying the onset of –– or warding off ...
47 minutes ago | not rated yet | 0 |
Chinese and U.S. scientists have used virus isolated from a person who died from H7N9 avian influenza infection to determine whether the virus could infect and be transmitted between ferrets. Ferrets are often used as a mammalian ...
1 hour ago | not rated yet | 0 |
By discovering the new mechanism by which estrogen suppresses lipid synthesis in the liver, UC Irvine endocrinologists have revealed a potential new approach toward treating certain liver diseases.
48 minutes ago | not rated yet | 0 |
Aortic arch pulse wave velocity, a measure of arterial stiffness, is a strong independent predictor of disease of the vessels that supply blood to the brain, according to a new study published in the June issue the journal ...
52 minutes ago | not rated yet | 0
A second child has contracted polio in a restive Pakistani tribal region near the Afghan border after the Taliban banned vaccinations there nearly a year ago, a UN official said Thursday.
18 minutes ago | not rated yet | 0