RESEARCH - Cardiovascular diseases more common in those with autoimmune disorders

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Cardiovascular Diseases More Common in Those With Autoimmune Disorders

NEW YORK (Reuters Health) Dec 22 - The prevalence of cardiovascular diseases

and their risk factors is higher in patients with rheumatoid arthritis (RA),

psoriatic arthritis (PsA), and ankylosing spondylitis (AS) than in subjects

without these disorders, according to a new study.

In a cross-sectional study, Dr. Chenglong Han, of Centocor, Inc., Malvern,

Pennsylvania, and colleagues compared the prevalence of cardiovascular

diseases and their risk factors between patients with RA, PsA and AS and

control subjects. The researchers evaluated data for patients continuously

enrolled in an integrated outcomes database between January 1, 2001, and

December 31, 2002, who met the criteria for RA, PsA, and AS. Control groups

were matched for each patient group (1:4 ratio) on the basis of age, sex,

geographic region, and length of time on plan.

The researchers calculated age- and sex-adjusted prevalence of

cardiovascular comorbidities and risk factors. They estimated the prevalence

of the comorbidities and risk factors for the patients groups compared with

the control groups. The use of cardiovascular medications was compared

between the groups. Results of the study are published in the November issue

of the Journal of Rheumatology.

Overall, 28,208 subjects had RA, 3066 had PsA, and 1843 had AS. The mean

ages of patients in these groups were 51.9, 49.7, and 47.3 years,

respectively. Compared to controls, patients with RA, PsA, and AS had higher

prevalence ratios of ischemic heart disease (1.5, 1.3, 1.2), atherosclerosis

(1.9, 1.4, 1.5), peripheral vascular disease (2.4, 1.6, 1.6), congestive

heart failure (2.0, 1.5, 1.8), cerebrovascular disease (1.6, 1.3, 1.7), type

2 diabetes (1.4, 1.5, 1.2), hyperlipidemia (1.2, 1.2, 1.2), and hypertension

(1.3, 1.3, 1.3).

" In patients with RA, PsA, and AS, use of ACE inhibitors, calcium channel

blockers, diuretics, nitrates/vasodilators, anticoagulants, and

antihyperlipidemia agents was significantly higher in patients than control

groups, " Dr. Han's team writes.

The study " adds to the evidence that cardiovascular disease may well be a

significant problem in AS and PsA, " write Drs. Tracey Farragher and Ian

Bruce, of the University of Manchester, in an accompanying editorial.

" Well-designed prospective studies are now needed to confirm whether

increased risk of cardiovascular disease in PsA and AS is primarily driven

by traditional risk factors, chronic inflammation, or the consequences of

treatment. "

J Rheumatol 2006;33:2167-2172

http://www.medscape.com/viewarticle/549840

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