RESEARCH - RA versus diabetes as a risk factor for cardiovascular disease: CARRE

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Ann Rheum Dis. Published Online First: 12 August 2008.

doi:10.1136/ard.2008.094151

Copyright © 2008 BMJ Publishing Group Ltd & European League Against

Rheumatism

--------------------------------------------------------------------------------

Extended Report

Rheumatoid arthritis versus diabetes as a risk factor for

cardiovascular disease, a cross sectional study. The CARRÉ

Investigation

V P van Halm 1, M JL s 1, A E Voskuyl 1, M Boers 2, W F lems 3, M

Visser 1, C DA Stehouwer 4, A MW Spijkerman 1, J M Dekker 1, G Nijpels

1, R J Heine 1, L M Bouter 1, Y M Smulders 1, B AC Dijkmans 1 and M T

Nurmohamed 2*

1 VU University Medical Center, Netherlands

2 VUMC, Netherlands

3 Vrije Universiteit Medisch Centrum, Netherlands

4 University Hospital Maastricht, Netherlands

Abstract

objectives: Patients with rheumatoid arthritis (RA) have an increased

cardiovascular risk, but the magnitude of this risk is not precisely

known. We therefore investigated the associations between RA and type

2 diabetes (DM2), a well-established cardiovascular risk factor, on

the one hand and cardiovascular disease (CVD) on the other.

Methods: We determined the prevalences of CVD, (i.e. coronary,

cerebral and peripheral arterial disease), in 353 randomly selected

outpatients with RA (diagnosed between 1989 and 2001, aged between 50

and 75 years; the CARRÉ study), and in participants of a

population-based cohort study on diabetes and CVD (the Hoorn study).

RA patients with normal fasting glucose levels from the CARRÉ study

(RA, n = 294) were compared to individuals from the Hoorn study with a

normal glucose metabolism (non-diabetic, n = 258), and individuals

with DM2 (DM2, n = 194).

Results: The prevalence of CVD was 5.0% (95%-CI: 2.3-7.7%) in

non-diabetic, 12.4% (95%-CI: 7.5-17.3%) in DM2, and 12.9% (95%-CI:

8.8-17.0%) in RA individuals. With non-diabetic individuals as

reference category, the age- and gender-adjusted prevalence odds ratio

(ORs) for CVD was 2.3 (95%-CI: 1.1-4.7) for individuals with DM2 and

3.1 (95%-CI: 1.6-6.1) for RA patients. There was an attenuation of the

prevalences after adjustment for conventional cardiovascular risk

factors (ORs: 2.0 (95%-CI: 0.9-4.5) and 2.7 (95%-CI: 1.2-5.9),

respectively).

Conclusions: The prevalence of CVD in RA is increased to an extent

that is at least comparable to that of DM2. This should have

implications for primary cardiovascular prevention strategies in RA.

http://ard.bmj.com/cgi/content/abstract/ard.2008.094151v2?papetoc

--

Not an MD

[Guest guest]

And several of us are so lucky that we have both RA and DM2, LOL, so we

get double the risk.

Sue

On Saturday, August 16, 2008, at 09:29 AM, wrote:

> Conclusions: The prevalence of CVD in RA is increased to an extent

> that is at least comparable to that of DM2. This should have

> implications for primary cardiovascular prevention strategies in RA.

[Guest guest]

I hear you.... I have RA, my mother and her sister and alll her family had

Adult-onset Diabetes. I'm waiting.... though trying not to get it!

>From: Sue <marysue@...>

>Reply-

>

>Subject: Re: [ ] RESEARCH - RA versus diabetes as a risk factor

>for cardiovascular disease: CARRE

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>And several of us are so lucky that we have both RA and DM2, LOL, so we

>get double the risk.

>

>Sue

>

>On Saturday, August 16, 2008, at 09:29 AM, wrote:

>

> > Conclusions: The prevalence of CVD in RA is increased to an extent

> > that is at least comparable to that of DM2. This should have

> > implications for primary cardiovascular prevention strategies in RA.

>

[Guest guest]

It's probably not double the risk, Sue.

Still, lucky you!

Not an MD

On Sat, Aug 16, 2008 at 12:10 PM, Sue <marysue@...> wrote:

> And several of us are so lucky that we have both RA and DM2, LOL, so we

> get double the risk.

>

> Sue

[Guest guest]

I wish I could be that lucky in lotteries, etc. LOL.

Sue

On Saturday, August 16, 2008, at 03:18 PM, wrote:

> It's probably not double the risk, Sue.

>

> Still, lucky you!

>