Long-Term Rheumatoid Arthritis Associated With Accelerated Atherosclerosis

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Long-Term Rheumatoid Arthritis Associated With Accelerated Atherosclerosis

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NEW YORK (Reuters Health) Jan 02 - Atherosclerotic manifestations in patients

with rheumatoid arthritis (RA) of approximately 20 years' duration are worse

than those of age- and sex-matched control subjects. The increased progression

appears to be related not so much to inflammatory mediators as to blood lipid

levels, the investigators report.

Thirty-nine patients who had RA onset 19 to 23 years previously and were younger

than 65 years old were compared with 39 control subjects. The findings are

reported in the Journal of Rheumatology for December.

The results of B-mode ultrasonography of the common carotid artery, Dr. Solveig

Wallberg-Jonsson, and colleagues at the University Hospital of Umea in Sweden,

found that the intima-media thickness was significantly greater in the RA group.

This measurement was associated with cholesterol, LDL, LDL/HDL ratio,

triglycerides, and tissue plasminogen activator antigen.

Echocardiography showed evidence of aortic cusp sclerosis/stenosis in 11

patients and 3 control subjects. Again, the adverse finding was related to

higher cholesterol and triglyceride levels, as well as soluble intercellular

adhesion molecule 1.

The Swedish researchers suggest that the association between rheumatoid

arthritis and atherosclerotic progression may result from continuous endothelial

activation or dysfunctional vasculature that is more affected by traditional

cardiovascular risk factors.

" It seems urgent that in addition to the treatment of their arthritis these

patients should be screened, and adequately treated for, other cardiovascular

risk factors, particularly presence of hyperlipidemia, even when not at extreme

levels, " Dr. Wallberg-Jonsson's team advises.

J Rheumatol 2001;28:2597-2602.

http://rheumatology.medscape.com/reuters/prof/2002/01/01.03/20020102epid001.html