Background People with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease (CVD) [1,2]. Although male gender is generally associated with a greater risk for cardiovascular related mortality and death, there is, as yet, little knowledge of the impact of gender on the risk factors for CVD in patients with RA.
Objectives To explore gender differences in the distribution of risk factors and in the risk factors that exceed national recommended levels in outpatients with RA.
Methods We used data from the first 836 outpatients in a hospital population with RA screened in 30-minute nursing consultations according to the EULAR recommendations [1,2]. Risk factors, such as history of CVD, hypertension or diabetes mellitus (DM), smoking, fasting glucose, total, LDL, HDL cholesterol and Triglycerides, exercise habits, alcohol use, Body Mass Index (BMI) and waist circumference were explored. Logistic regression analyses were used to test for gender differences.
Results Fewer female than male patients were diagnosed with CVD (OR 0.662; CI 0.452, 0.965; p=0.032) and there were no gender differences in those diagnosed with DM. In the 644 patients without CVD or DM, male patients were more likely to smoke, drink more alcohol than recommended (p<0.001), and to have higher blood pressure (p=0.026) and lower total cholesterol (p=0.006), but to have a higher total-cholesterol/HDL-cholesterol ratio (p<0.001) than female patients. More male patients than female patients displayed too low HDL-cholesterol levels (p=0.014). When comparing female and male patients, and taking the deviations from the recommended levels for the different risk factors into account, female patients had a small but significantly lower risk for elevated blood pressure (OR 0.987) but a higher risk for an increase in waistline above the recommended limits than the male patients (OR 1.023). In addition, female patients had a lower odds ratio (OR 0.681) for an increase in fasting glucose compared to male patients.
Conclusions In clinical practice, we need to be aware of gender differences in risk factors for development of CVD in order to target interventions.
Peters, M.J., et al., EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis, 2010. 69(2): p. 325-31.
Primdahl J, Clausen J, Hørslev-Petersen K. Results from implementation of systematic screening for cardiovascular risk according to the EULAR recommendations in outpatients with rheumatoid arthritis. Ann Rheum Dis 2013; 72: 11:1771-6
Disclosure of Interest None declared