RESEARCH - RA is associated with a high prevalence of hypothyroidism that amplifies its cardiovascular risk

[Guest guest]

Ann Rheum Dis. 2008 Feb;67(2):229-32. Epub 2007 Jun 8.

Rheumatoid arthritis is associated with a high prevalence of

hypothyroidism that amplifies its cardiovascular risk.

Raterman HG, van Halm VP, Voskuyl AE, Simsek S, Dijkmans BA, Nurmohamed MT.

Department of Rheumatology, VU University Medical Center, Amsterdam,

The Netherlands.

OBJECTIVE: Rheumatoid arthritis (RA) patients have an increased risk

of developing cardiovascular diseases (CVD). Other autoimmune diseases

such as hypothyroidism are also associated with an enhanced risk for

CVD. Our objective was to determine first, the prevalence of

hypothyroid disorders in RA patients, and second, the risk of CVD in

RA patients with hypothyroid abnormalities.

METHODS: SUBJECTS: were RA patients who participated in an ongoing

prospective cohort study of cardiovascular mortality and morbidity (n

= 358) in which hypothyroid abnormalities were assessed. CVD was

defined as a verified medical history of coronary, cerebral or

peripheral arterial disease.

RESULTS: Clinical hypothyroidism was observed in 16 of 236 female RA

patients (6.8%), which is significantly higher than in the general

population of The Netherlands. Subclinical hypothyroidism was detected

in 6 out of 236 RA women (2.5%). In female RA patients, CVD was

present in 6 out of 16 (37.5%) of all hypothyroid women. The odds

ratio for CVD comparing female hypothyroid RA patients with female

euthyroid RA patients was 4.1 (95% CI 1.2-14.3) after adjustment for

sex, age, diabetes, smoking (ever), hypertension and statin use.

CONCLUSIONS: Clinical hypothyroidism was observed three times more

often in female RA patients than females in the general population. In

female RA patients, clinical hypothyroidism was associated with a

fourfold higher risk of CVD in comparison with euthyroid female RA

patients independently of the traditional risk factors.

PMID: 17557891

http://www.ncbi.nlm.nih.gov/pubmed/17557891

Not an MD