Cardiovascular care and cancer screening in female nurses with and without RA

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Arthritis Rheum. 2004 Jun 15;51(3):429-32.

Cardiovascular care and cancer screening in female nurses with and

without rheumatoid arthritis.

DH, Karlson EW, Curhan GC.

Brigham and Women's Hospital, Harvard Medical School, Boston,

Massachusetts.

OBJECTIVE: To compare frequencies of cancer screening and cardiovascular

treatments aimed at reducing acute myocardial infarction in women with

and without rheumatoid arthritis (RA). METHODS: Data from the

prospective Nurses' Health Study were analyzed for the 491 women

diagnosed with RA prior to 1998 and the 82,884 women without RA.

Cardiovascular treatments included aspirin use, treatment with a

cholesterol-lowering agent, cardiac catheterization, and coronary artery

revascularization; cancer screening consisted of mammography and

bimanual pelvic examinations. Adjustments were made for potential

confounders using multivariate logistic regression. RESULTS: After

adjusting for cardiovascular risk factors, use of nonsteroidal

antiinflammatory drugs, and a history of gastric or duodenal ulcer,

women with RA and no history of cardiac disease were 35% less likely to

report taking aspirin regularly (odds ratio [OR] 0.65, 95% confidence

interval [95% CI] 0.51-0.84). The use of cholesterol-lowering treatment,

angiography, and revascularization was not statistically different in

women with and without RA. After adjusting for cancer risk factors,

there appeared to be an increased likelihood of mammography in women

with RA compared with those without RA (OR 1.41, 95% CI 0.97-2.04),

although this result was not statistically significant. Bimanual pelvic

examination was reported with similar frequency between the 2 groups.

CONCLUSION: Other than aspirin use, care to prevent acute myocardial

infarction and cancer screening practices were similar among women with

RA compared with women without RA.

PMID: 15188329

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