Association between cardiovascular risk factors and the occurrence of giant cell arteritis: a systematic review and meta-analysis

• Published in: Rheumatology (Oxford, England) Vol. 64; no. 8; pp. 4525 - 4538
• Main Authors: Barde, François, Pacoureau, Lucas, Elbaz, Alexis, Seror, Raphaèle, Nguyen, Yann
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.08.2025; Oxford Publishing Limited (England); Oxford University Press (OUP)
• Subjects: Arteritis; Body weight; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - complications; Cardiovascular Diseases - epidemiology; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Dyslipidemia; Epidemiology; Giant Cell Arteritis - epidemiology; Giant Cell Arteritis - etiology; Heart Disease Risk Factors; Humans; Hypertension - epidemiology; Life Sciences; Meta-analysis; Obesity - epidemiology; Overweight; Risk Factors; Smoking - epidemiology; Systematic review; giant cell arteritis; cardiovascular disease; smoking; meta-analysis; diabetes mellitus; cardiovascular risk factors; dyslipidemia; systematic review; hypertension; polymyalgia rheumatica
• ISSN: 1462-0324; 1462-0332; 1462-0332
• DOI: 10.1093/rheumatology/keaf164

Abstract Objectives We aimed to analyse the association between cardiovascular risks factors and the onset of GCA through a systematic review and meta-analysis of observational studies. Methods Three databases (Medline, Embase, Web of Science) were systematically reviewed. Epidemiological studies on the association between six cardiovascular risk factors (type 2 diabetes, hypertension, dyslipidaemia, smoking, overweight/obesity, history of a cardiovascular disease) and the risk of GCA were eligible. Risk of bias was assessed using the ROBINS-E scale. Pooled associations for studies assessing the same outcome were reported as odds ratios (ORs) with their 95% CIs. Results The search strategy identified 4210 references, of which 43 studies were analysed and 17 were included in the meta-analysis (11 case–control studies, 4 cohort studies and 2 cross-sectional studies). An inverse association was found between type 2 diabetes and risk of GCA (OR = 0.75, 95% CI 0.61–0.93), whereas history of cardiovascular disease was positively associated with risk of GCA (OR = 1.28, 95% CI 1.18–1.38). In addition, the analysis identified a trend towards a decreased risk of GCA in overweight participants (OR 0.64; 95% CI 0.41–1.00). Conclusion Our study showed an inverse association between type 2 diabetes and risk of GCA, and a positive association between a history of cardiovascular disease and risk of GCA. It also identified a trend towards an inverse association between overweight and risk of GCA. The pathophysiological mechanisms underlying these findings may involve an effect of cardiovascular risk factors themselves, a condition underlying these factors (such as diet), or a condition following the diagnosis of cardiovascular disease (such as a treatment).