scholarly journals Cardiovascular Disease in Rheumatoid Arthritis: A Systematic Literature Review in Latin America

Arthritis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-17 ◽  
Author(s):  
Juan Camilo Sarmiento-Monroy ◽  
Jenny Amaya-Amaya ◽  
Juan Sebastián Espinosa-Serna ◽  
Catalina Herrera-Díaz ◽  
Juan-Manuel Anaya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Literature Review ◽  
Cardiovascular Risk Factors ◽  
Systematic Literature Review ◽  
Long Duration ◽  
Major Predictor ◽  
Traditional Risk Factors

Background. Cardiovascular disease (CVD) is the major predictor of poor prognosis in rheumatoid arthritis (RA) patients. There is an increasing interest to identify “nontraditional” risk factors for this condition. Latin Americans (LA) are considered as a minority subpopulation and ethnically different due to admixture characteristics. To date, there are no systematic reviews of the literature published in LA and the Caribbean about CVD in RA patients. Methods. The systematic literature review was done by two blinded reviewers who independently assessed studies for eligibility. The search was completed through PubMed, LILACS, SciELO, and Virtual Health Library scientific databases. Results. The search retrieved 10,083 potential studies. A total of 16 articles concerning cardiovascular risk factors and measurement of any cardiovascular outcome in LA were included. The prevalence of CVD in LA patients with RA was 35.3%. Non-traditional risk factors associated to CVD in this population were HLA-DRB1 shared epitope alleles, rheumatoid factor, markers of chronic inflammation, long duration of RA, steroids, familial autoimmunity, and thrombogenic factors. Conclusions. There is limited data about CVD and RA in LA. We propose to evaluate cardiovascular risk factors comprehensively in the Latin RA patient and to generate specific public health policies in order to diminish morbi-mortality rates.

scholarly journals High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

2019 ◽  
Vol 59 (1) ◽  
Author(s):  
Maria Fernanda Brandão de Resende Guimarães ◽  
Carlos Ewerton Maia Rodrigues ◽  
Kirla Wagner Poti Gomes ◽  
Carla Jorge Machado ◽  
Claiton Viegas Brenol ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Activity ◽  
Cardiovascular Risk Factors ◽  
Laboratory Data ◽  
Premature Cardiovascular Disease ◽  
Prevalence Of Obesity ◽  
The Mean

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

scholarly journals Cardiovascular Risk in Rheumatoid Arthritis

2021 ◽  
Author(s):  
Alexandru Caraba ◽  
Flavia Corina Babalic ◽  
Andreea Munteanu ◽  
Otilia Tomulescu
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Inflammatory Rheumatic Diseases ◽  
Atherosclerotic Cardiovascular Disease ◽  
Eular Recommendations ◽  
Related Risk ◽  
Traditional Risk Factors ◽  
Artery Disease

Rheumatoid arthritis (RA), one of the most common inflammatory rheumatic diseases. It is defined as a chronic destructive and deforming arthropathy; it also finds its expression through systemic manifestations. RA has an undulating evolution, with remissions and relapses. Atherosclerotic cardiovascular disease represents one of the most common extra-articular manifestations of RA. It is known that the cardiovascular (CV) morbidity and mortality represent one of the leading causes of reduced life expectancy in RA. Patients with RA develop a premature and accelerated atherosclerosis, explaining the high incidence and prevalence of angina, myocardial infarction, congestive heart failure, stroke, peripheral artery disease, and the need for revascularization. Traditional risk factors (arterial hypertension, obesity, smoking, dyslipidemia, insulin resistance and metabolic syndrome, diabetes mellitus, male gender, physical inactivity) interplay with RA-related risk factors, generating endothelial dysfunction, arterial stiffness, carotid plaque, and atherosclerosis. Traditional cardiovascular risk factors alone cannot explain the increased incidence of premature and accelerated atherogenesis. Chronic inflammation, hyperhomocysteinemia, and hypercoagulation act as novel cardiovascular risk factors. Rheumatoid inflammation exerts direct effects on vessels, or by means of altered traditional risk factors. Antirheumatic drugs may promote atherogenesis or by reducing systemic inflammation may decrease cardiovascular risk. EULAR recommendations require annual cardiovascular risk assessment.

Cardiovascular Disease Prevention

2014 ◽  
pp. 860-869
Author(s):  
Jonathan D. Brown ◽  
Jorge Plutzky
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Tobacco Use ◽  
Prognostic Value ◽  
Male Gender ◽  
Traditional Risk Factors ◽  
Diagnostic And Prognostic Value

This chapter focuses on how cardiovascular risk factors contribute to the initiation and progression of coronary heart disease (CHD). Cardiovascular risk factors are currently grouped into traditional and nontraditional types. Traditional risk factors include hyperlipidemia (or dyslipidemia), tobacco use, hypertension, diabetes mellitus, age, male gender, and family history, all of which have been linked to CHD, an association substantiated through multiple large prospective population studies. The categories can be further subdivided into modifiable and nonmodifiable factors: with dyslipidemia, tobacco use, hypertension, and diabetes comprising the former. In spite of their undeniable diagnostic and prognostic value, a portion of the population lacking these traditional risk factors remains at significant residual risk for CHD.

P0278CARDIOVASCULAR RISK FACTORS AND THE LONG TERM OUTCOME OF LUPUS NEPHRITIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marwa Omrane ◽  
Raja Aoudia ◽  
Mondher Ounissi ◽  
Soumaya Chargui ◽  
Mouna Jerbi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Renal Failure ◽  
Cardiovascular Risk ◽  
Lupus Nephritis ◽  
Cardiovascular Risk Factors ◽  
Increased Risk ◽  
Traditional Risk Factors

Abstract Background and Aims Systemic Lupus Erythematosus (SLE) is associated with an increased risk of cardiovascular morbidity and cardiovascular mortality. The risk of cardiovascular events is 1.3–2.7 times higher in SLE patients than in the general population, and even higher in patients with lupus nephritis (LN). Traditional risk factors as well as SLE-specific and treatment-related factors all contribute to the increased risk of cardiovascular disease. The primary aim of the present study was to evaluate cardiovascular risk factors, morbidity and mortality in patients with LN. Method This is a retrospective study of patients over the age of 16, with LN proved by kidney biopsy and followed up in our department over a period of 17 years. The diagnosis of lupus was made according to criteria of The American College of Rheumatology revised in 1997. Demographic, clinical and para-clinical data were collected from medical observations. Results We collected 155 women and 19 men with a sex ratio F / H of 8.2. The mean age at the time of the discovery of LN was 32.6 years [15-45 years]. Overall median follow-up time was 81.2 months. Renal symptomatology was dominated by proteinuria noted in all patients with an average proteinuria at 3.3 g / 24h, associated to a nephrotic syndrome in 68% of patients, hematuria was present in 69% of patients and renal failure was present in half of cases with an average serum creatinine of 110 µmol / l. At the time of diagnosis of LN, hypertension was noted in 48.9% of cases, diabetes in 2.8% of cases and obesity in 57.4% of cases with an index average body mass of 28.5 Kg / m2. Smoking was reported in 17.2% of the cases. The average cholesterol level was 5,5±2,1 mmol/l, the average triglycerid level was 2,5±1,1 mmol/. Antiphospholipid syndrome was found in 14.9% of cases. We performed 243 renal biopsies with 174 initial and 69 iterative biopsies. The histological lesions were polymorphic dominated by LN class IV (54.3%), arteriolosclerosis was observed in 47.7% and lesions of thrombotic microangiopathy in 29.8%. Corticosteroid therapy was prescribed in all patients combined with immunosuppressive therapy in 54.6% of cases. The overall survival of the patients at 10 years was 85%. During follow-up, cardiovascular complications found in our series were mainly strokes (6.3%) and coronary insufficiency (5.2%) and transient ischemic attack (6.9%). After a univariate analysis, the additional cardiovascular risk factors identified in our study were antiphospholipid syndrome (p = 0.01), renal failure (p = 0.01), long-term corticosteroid therapy (p = 0.009), the chronicity of the disease (evolution of lupus&gt; 10 years) (p = 0.014), proliferative forms (p=0.001), arteriolosclerosis (p=0.0002) and lesions of thrombotic microangiopathy (p=0.018). Survival in patients without cardiovascular risk factors was better (96% vs 88%). Conclusion In conclusion, in addition to traditional risk factors SLE patients have several disease related risk factors that explain increase cardiovascular disease. A careful control for this risk factors is essential to continuously improve survival in SLE.

scholarly journals The types of left ventricular remodeling in patients with rheumatoid arthritis

2020 ◽  
Vol 14 (2) ◽  
pp. 62-68
Author(s):  
I. A. Krivotulova ◽  
K. V. Korochina ◽  
T. V. Chernysheva ◽  
G. E. Kuznetsov ◽  
L. R. Tenchurina
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Drug Therapy ◽  
Cardiovascular Risk Factors ◽  
Left Ventricular ◽  
Patient Age ◽  
Patient Âgé ◽  
Lv Remodeling ◽  
Traditional Risk Factors

Studying the factors leading to a pathological change in the cardiac structure in patients with rheumatoid arthritis (RA) can contribute to improvement in early diagnosis and to prevention of premature mortality from cardiovascular events.Objective. To study the types of left ventricular (LV) remodeling in patients with RA, by taking into account traditional cardiovascular risk factors, and to assess the clinical and immunological features of RA and the impact of drug therapy.Patients and methods. The investigation enrolled 74 RA patients who underwent assessment of echocardiography findings, by determining the type of LV remodeling, traditional cardiovascular risk factors, clinical and immunological features of the disease, as well as the current drug therapy.Results and discussion. Eccentric LV hypertrophy (ELVH) (n=33 (44.59%)) and concentric LV hypertrophy (CLVH) (n=34 (45.95%)) occurred at almost the same frequency among the pathological types of LV remodeling in patients with RA. Higher DAS28 values (p<0.0001) were noted in ELVH than in CLVH. There were also positive correlations of EHLH with ESR and CRP level (r= 0.51, p<0.0001; r=0.48, p=0.0001, respectively). The higher values of systolic blood pressure (p=0.0002), body mass index (p=0.01), patient age (p=0.0001), and the incidence of dyslipidemia (p= 0.008) were established in CVLH than in ELVH. LV diastolic dysfunction (DD) was detected much more frequently in RA patients with CLVH than in those with ELVH (p=0.01). The DD parameters (peak A, E/A) correlated with the degree (r=0.5, p<0.0001; r=-0.5. p<0.0001) and stage of hypertension (r=0.54, p<0.0001; r=-0.48, p=0.0001, respectively), as well as with peak A and traditional risk factors, such as patient age (r=0.52, p<0.0001), and high-density lipoprotein cholesterol levels (r=-0.48, p=0.0001).Conclusion. Most patients with RA had signs of LV hypertrophy; moreover, ELVH was closely linked with disease activity, whereas CLVH was related to the traditional risk factors.

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