Cardiovascular risk factors are negatively associated with rheumatoid arthritis disease outcomes

• Published in: Therapeutic advances in musculoskeletal disease Vol. 13; p. 1759720X20981217
• Main Authors: Cui, Kangping, Movahedi, Mohammad, Bombardier, Claire, Kuriya, Bindee
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 2021; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Cardiovascular disease; Clinical outcomes; Comorbidity; Medical prognosis; Original Research; Rheumatoid arthritis; Risk factors; disease activity; risk factors; cardiovascular; prognosis; rheumatoid arthritis
• ISSN: 1759-720X; 1759-7218
• DOI: 10.1177/1759720X20981217

Aims: Rheumatoid arthritis (RA) is associated with cardiovascular disease (CVD), but the influence of CVD risk factors on RA outcomes is limited. We examined if CVD risk factors alone are associated with RA disease activity and disability. Methods: We performed a cross-sectional analysis of participants in the Ontario Best Practices Research Initiative, RA registry. Patients were categorized into mutually exclusive CVD categories: (1) No established CVD and no CVD risk factors; (2) CVD risk factors only including ⩾1 of hypertension, dyslipidemia, diabetes, or smoking; or (3) history of established CVD event. Multivariable regression analyses examined the effect of CVD status on Disease Activity Score 28 (DAS28-ESR), Clinical Disease Activity Index (CDAI), and Health Assessment Questionnaire Disability Index (HAQ-DI) scores at baseline. Results: Of 2033 patients, 50% had at least 1 CVD risk factor, even in the absence of established CVD. The presence of ⩾1 CVD risk factor was independently associated with higher CDAI [β coefficient 1.59, 95% confidence interval (CI) 0.29–2.90, p = 0.02], DAS28-ESR (β coefficient 0.20, 95% CI 0.06–0.34, p = 0.01) and HAQ-DI scores (β coefficient 0.15, 95% CI 0.08–0.22, p < 0.0001). The total number of CVD risk factors displayed a dose response, as >1 CVD risk factor was associated with higher disease activity and disability, compared with having one or no CVD risk factors. Conclusion: CVD risk factors alone, or in combination, are associated with higher disease activity and disability in RA. This emphasizes the importance of risk factor recognition and management, not only to prevent CVD, but also to improve potential RA outcomes.