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SAT0445 Risk of Cardiovascular Disease in Patients with Osteoarthritis: Results from the Must-Heart Study
  1. I.K. Eeg1,2,
  2. S. Rollefstad1,
  3. I.K. Haugen1,
  4. I.C. Olsen1,
  5. N. Østerås1,
  6. B. Slatkowsky-Christensen1,
  7. H.B. Hammer1,
  8. L. Nordsletten2,3,
  9. B. Natvig4,
  10. T.K. Kvien1,2,
  11. A.G. Semb1
  1. 1Rheumatology, Diakonhjemmet hospital
  2. 2Faculty of Medicine, University of Oslo
  3. 3Orthopaedic Surgery, Oslo University Hospital Ullevaal
  4. 4General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway

Abstract

Background Controversies exist regarding whether patients with osteoarthritis (OA) have an increased risk of cardiovascular (CV) disease.

Objectives Our aim was to evaluate the CV risk in a population-based OA cohort.

Methods The Musculoskeletal pain in Ullensaker STudy (MUST) is a cross-sectional investigation comprising a thorough clinical examination, recording of CV risk factors in addition to radiographic evaluation of hands, hips and knees of persons with self-reported OA (The MUST-Heart study). Of the 604 persons examined, 438 fulfilled the ACR classification criteria for OA in the hand, knee and/or hip joints. The study population was divided into: 1) generalized OA, defined as bilateral hand OA or involvement of ≥3 out of 6 sites (bilateral hand/hip/knee); 2) focal OA; or 3) non-OA. CV risk was calculated by the SCORE algorithm1 for persons without CV disease, not using lipid lowering and/or antihypertensive medication (OA n=200 and non-OA n=87). An estimated CV risk <5% for experiencing a fatal myocardial infarction coming 10 years is defined as low to medium risk, while ≥5% is the cut off for initiation of CV preventive pharmacotherapy. Comparisons between groups were done by using independent samples T-test, Mann Whitney-U and χ2 as appropriate.

Results The median CV risk for patients with OA [1.40 (IQR 0.65, 2.92)] was significantly higher compared to non-OA [0.99 (IQR 0.52, 1.92)] (p=0.02). The difference in the CV risk was related to higher age (p<0.001), but not to total cholesterol (p=0.07), systolic blood pressure (p=0.13) or to the OA diagnosis. Only 17/200 (8.5%) of the OA patients and 3/87 (3.4%) of the non-OA persons had a CV risk ≥5% (p=0.12). The presence of established CV disease was comparable for those with (n=72/438, 16.8%) and without OA (n=34/166, 21.1%) (p=0.23). Dividing the OA group into focal and generalised OA, did not reveal any further differences regarding estimated CV risk or CV disease compared with non-OA. Inflammatory biomarkers (erythrocyte sedimentation rate and C-reactive protein) were in the normal range for the whole study population, with no difference between OA and non-OA (p=0.30 and 0.10, respectively).

Conclusions Inhabitants with OA in a Norwegian municipality had an overall low risk of CV disease and did not have higher prevalence of established CV disease compared to non-OA.

References

  1. Perk J, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Atherosclerosis 2012; 223(1):1-68.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.2479

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