Research is constantly refining our understanding of disease. We know that the inflammation caused by rheumatoid arthritis is a cause of joint pain. Recently, multiple studies also suggest a link between rheumatoid arthritis and increased risk of heart disease.
Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system attacks joint tissues, causing inflammation of the joint lining. RA can affect many different joints, as well as other parts of the body including the eyes, lungs, and heart. Studies point to RA as an increased risk for heart disease because the inflammation caused by RA also accelerates scarring and clogging of the arteries.
A meta-analysis study published in the Annals of the Rheumatic Diseases, the journal of the European League Against Rheumatism (EULAR), reviewed 19 studies of the incidence of heart disease and rheumatoid arthritis in almost 100,000 patients. The findings indicated a strong link between RA and accelerated heart disease: RA increased the risk of cardiovascular death by 60 percent compared to people who do not have RA.
The study also suggests a link between RA and atrial fibrillation, the most common type of arrhythmia. An arrhythmia is a problem with the rate or rhythm of the heartbeat. People with atrial fibrillation may not feel symptoms, but this condition can increase risk of stroke or heart failure.
More research must be done. As we learn more, it is important to understand that traditional risk score calculations to assess cardiovascular risk can underestimate the heart risk in RA patients, because these patients have not been included in large clinical trials for primary cardiac prevention in the past.
The EULAR findings are significant enough to demonstrate a strong association of accelerated heart disease in patients with inflammatory arthritis. Accordingly, the study recommends focused care for patients with RA, and encourages clinicians to increase their scrutiny of patients with inflammatory arthritis. Recommended steps include an annual assessment of RA patients for cardiovascular risk factors like cholesterol and blood pressure. It is also particularly important for RA patients to avoid smoking, another risk factor for heart disease.
Until further research is able to identify the optimal care to prevent or address this risk, a yearly cardiac assessment can help to identify and treat any symptoms before they become serious.