RESEARCH - Young RA patients at high cardiovascular risk

January 7, 2007

Young RA Patients at High Cardiovascular Risk

NEW YORK (Reuters Health) Dec 26 - Youth offers patients with rheumatoid

arthritis (RA) little in the way of protection against adverse

cardiovascular events, researchers report in the December issue of ls of

the Rheumatic Diseases.

" RA is an important risk factor for cardiovascular disease, " lead

investigator Dr. H. noted in comments to Reuters Health.

" While the absolute increase in risk is largest among older patients, the

risk is also significant in younger patients. "

Dr. and colleagues at Brigham and Women's Hospital, Boston compared

more than 25,000 Canadian adults with RA to a matched cohort without RA.

Over the 5-year study period, 375 RA patients were hospitalized for

myocardial infarction, 363 were hospitalized for stroke, 437 died from

cardiovascular causes. In all, 1042 experienced at least one of these

outcomes.

The rate ratio for such events in RA patients was 1.6 and the rate

difference was 5.7 per 1000 person-years. The rate ratio decreased with age,

falling from 3.3 in patients aged 18 to 39 years to 1.6 in those aged 75

year or more.

However, in the youngest patients, the rate difference was 1.2 per 1000

person-years, compared to 19.7 per 1000 person years in the oldest group.

Unexpectedly, the researchers point out, the risk of subsequent

cardiovascular events was not increased in RA patients who had experienced a

previous cardiovascular event. A possible explanation, they suggest, is that

RA patients who survive such an event are healthier than equivalent controls

and are less likely to experience another such event.

Dr. concluded that, given the findings, " patients, doctors, and the

health care system must focus on cardiovascular risk factor modification for

patients with rheumatoid arthritis, including careful blood pressure

control, lipid lowering when appropriate, smoking cessation, and enhancing

physical activity. "

Ann Rheum Dis 2006;65:1608-1612

Not an MD

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