CLINICAL AND EPIDEMIOLOGICAL RESEARCH

Extended report

Hand osteoarthritis in older women is associated with carotid and coronary atherosclerosis: the AGES Reykjavik study

H Jonsson¹, G P Helgadottir², T Aspelund³, G Eiriksdottir⁴, S Sigurdsson⁴, T Ingvarsson⁵, T B Harris⁶, L Launer⁶, V Gudnason⁴

¹ Landspitalinn University Hospital, Reykjavik, Iceland
² University of Iceland, Reykjavik, Iceland
³ Icelandic Heart Association, University of Iceland, Reykjavik, Iceland
⁴ Icelandic Heart Association, Reykjavik, Iceland
⁵ Akureyri Central Hospital, Akureyri, Iceland
⁶ National Institute on Aging, Bethesda, Maryland, USA

^{Correspondence to} Dr H Jonsson, Landspitalinn University Hospital, Department of Rheumatology, Fossvogur, IS 108 Reykjavik, Iceland; helgijon{at}landspitali.is

Objective: There is evidence that atherosclerosis may contribute to the initiation or progression of osteoarthritis. To test this hypothesis, the presence and severity of hand osteoarthritis (HOA) was compared with markers of atherosclerotic vascular disease in an elderly population.

Patients and Methods: The AGES Reykjavik Study is a population-based multidisciplinary study of ageing in the elderly population of Reykjavik. In a study of 2264 men (mean age 76 years; SD 6) and 3078 women (mean age 76 years; SD 6) the severity of HOA, scored from photographs, was compared with measures of atherosclerosis. These included carotid intimal thickness and plaque severity, coronary calcifications (CAC) and aortic calcifications and reported cardiac and cerebrovascular events.

Results: After adjustment for confounders, both carotid plaque severity and CAC were significantly associated with HOA in women, with an odds ratio of 1.42 (95% CI 1.14 to 1.76, p = 0.002) for having CAC and 1.25 (95% CI 1.04 to 1.49, p = 0.016) for having moderate or severe carotid plaques. Both carotid plaques and CAC also exhibited significant linear trends in relation to HOA severity in women in the whole AGES Reykjavik cohort (p<0.001 and p = 0.027, respectively, for trend). No significant associations were seen in men. Despite this evidence of increased atherosclerosis, women with HOA did not report proportionally more previous cardiovascular or cerebrovascular events.

Conclusions: The results indicate a linear association between the severity of HOA and atherosclerosis in older women. The pathological process of HOA seems to have some components in common with atherosclerosis. Prospective studies may help elucidate the possible mechanisms of this relationship.

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