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Dyslipidaemia and rheumatoid arthritis
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In this issue of the Annals of the Rheumatic Diseases, Munro and colleagues1 report a comparative study of intramuscular gold and hydroxychloroquine in rheumatoid arthritis (RA). They demonstrate a beneficial effect of hydroxychloroquine on lipid profiles compared with gold and suggest that hydroxychloroquine might be considered for RA patients at adverse cardiovascular risk.
Should rheumatologists be interested in their patients' cardiovascular and lipid status? The answer to this question is an unqualified `yes'. Several studies suggest that cardiovascular diseases account for about half of all deaths in RA.2 Cardiovascular deaths are more pronounced in the younger age group (<55 years), and may contribute to the substantial reduction in life expectancy, with estimates of standardised mortality ratios ranging from 1.1 to 3.3
We previously suggested that cardiovascular disease in RA may result
from accelerated atherosclerosis caused by clinical or subclinical
vasculitis.4 The main determinants of cardiovascular risk
in the general
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