Background Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular (CV) events. Since 2011, RA is considered as an independent risk factor for cardiovascular disease (CVD) in the Dutch cardiovascular risk management (CV-RM) guidelines . To date it is unknown whether RA patients receive adequate preventive treatment for CV risk as described in the guidelines.
Objectives To investigate if and to what extent the Dutch CV-RM guidelines are implemented in the RA population.
Methods Consecutive patients were recruited from two outpatient rheumatology clinics: 1. Reade, Centre of revalidation and rheumatology in Amsterdam and 2. Antonius Hospital in Sneek. CV risk factors, including age, systolic blood pressure, smoking status and total cholesterol/HDL-cholesterol ratio were assessed and subsequently, the 10-years CV risk was calculated. A 10-year risk of developing a cardiovascular event of 20% or higher was classified as high CV risk. A risk below 10% was classified as low and 10 to 20% as intermediate CV risk.
Results In total, 390 RA patients were included in this study: 125 from Antonius Hospital and 265 from Reade.
Table 1 displays the relevant demographic and cardiovascular risk factors of the total population and the two rheumatology clinics separately.
Of the total group 269 RA patients (69%) had a high, 57 (15%) an intermediate and 64 (16%) a low 10-year CV risk (figure 2).
Ninety percent of the high CV risk patients should be treated with antihypertensive and/or statin treatment, however only 45% actually used one or both medications (figure 2).
Conclusions Two third of the RA patients have a high cardiovascular risk and need cardiovascular risk management. Strikingly, in half of these patients adequate CV-RM is lacking.
Therefore, strategies to optimize CV-RM in RA patients are urgently needed.
The Dutch College of General Practitioners, Multidisciplinary guidelines for cardiovascular risk management, revision 2011
Disclosure of Interest None declared