Background Patients with rheumatic diseases are at higher risk of cardiovascular disease (CVD). Current recommendations for the management of cardiovascular risk factors are unfortunately not well applied in all our rheumatic patients.
Objectives To determine the presence of cardiovascular risk factors (CVRF) in patients diagnosed with a rheumatic disease and assess whether patients receiving treatment for these CVRF have better control than patients not receiving such therapies.
Methods All patients presenting to a Rheumatology clinic at a local Spanish hospital between september and november 2013 were studied, selecting those with an established diagnosis of a rheumatic disease. Age, sex, rheumatic disease and CVRF were collected, as well as therapy status for hypertension, hypercholesterolemia, hypertriglyceridemia and diabetes. CVRF analyzed were: smoking and alcohol status, presence of CVD, sedentary lifestyle, body mass index (BMI) and levels of cholesterol, triglycerides (TG), glucose, systolic blood pressure (SBP) and diastolic (DBP). Levels were considered normal: BMI <25, cholesterol <250 mg/dL, TG <185 mg/dL, glucose <110 mg/dL, SBP <140 mmHg and DBP <90 mmHg. Data were collected and analyzed in an openoffice Calc database, performing a t-student test to compare quantitative variables, considered statistically significant if p<0.05.
Results 471 patients (66.5% female and 33.5% male) were included in the study. Mean age was 59.22±15.41. Patients' established rheumatic diseases are summarized in Table 1. Given the presence of CVRF, 67 patients (14.2%) smoked, 81 (17.2%) drank alcohol, 73 (15.5%) had concomitant CVD and 395 (83.9%) were sedentary. Mean values for the collected determinations were: cholesterol 208.58±39.19 mg/dL, TG 123.84±75.30 mg/dL, glucose 100.40±25.19 mg/dL, SBP 137.73±21.30 mmHg and DBP 78.30±11.00 mmHg; Mean calculated BMI was 29.36±5.65. Regarding treatment, 211 (44.8%) patients received antihypertensive therapy, 110 (23.4%) anticholesterolemics, 30 (6.4%) TG-modifying agents and 66 (14%) antidiabetic agents. Comparing patients receiving any treatment for CVRF versus those not receiving it, it was observed that those taking antihypertensives had higher SBP values than those not taking them (142.80±23.45 mmHg vs 133.64±18.43 mmHg; p<0.01). Similar results were observed in patients taking TG-modifying agents (205.17±103.51 mg/dL vs 118.31±69.77 mg/dL; p<0.01) and antidiabetic agents (132.89±44.48 mg/dL vs 95.10±14.81 mg/dL; p<0.01). Only the group of patients who took anticholesterolemics had lower cholesterol levels compared to those who did not receive them, but no significant differences were observed between both groups (203.00±42.95 mg/dL vs 210.28±37.83 mg/dL; p=0.088). Sedentary patients had a higher BMI than those who practiced some exercise (29.75±5.66 vs 27.36±5.16; p=0.01).
Conclusions A considerable number of rheumatic patients have CVRF, highlighting physical inactivity as the most frequent (about 85%). Our results point out the inadequate control of CVRF (especially regarding hypertension, hyperglycemia and hyperTG) in spite of the therapy given. This findings emphasize the need of a more appropriate treatment of our patients in order to achieve better control of their CVRF.
Disclosure of Interest None declared