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Disability and not osteoarthritis predicts cardiovascular disease: a prospective population-based cohort study
  1. T A Hoeven1,2,
  2. M J G Leening2,3,
  3. P J Bindels1,
  4. M Castaño-Betancourt2,4,
  5. J B van Meurs4,
  6. O H Franco2,
  7. M Kavousi2,
  8. A Hofman2,
  9. M A Ikram2,5,6,
  10. J C M Witteman2,
  11. S M Bierma-Zeinstra1,7
  1. 1Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
  2. 2Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
  3. 3Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands
  4. 4Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
  5. 5Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
  6. 6Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
  7. 7Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Theun A Hoeven, Department of General Practice, Erasmus University Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands; t.hoeven{at}erasmusmc.nl

Abstract

Background Previous studies found an association between osteoarthritis (OA) and risk of cardiovascular disease (CVD) and therefore suggested intensive treatment of cardiovascular risk factors in OA patients. However, prospective population-based data is lacking.

Objectives To investigate the association between OA and CVD longitudinally in a general population and examine the role of disability in this association.

Methods This study was embedded in the Rotterdam Study, a prospective population-based cohort study in Rotterdam, the Netherlands that started in 1989. At baseline 4648 persons aged ≥55, free of CVD were classified into those with and those without radiographic or clinical OA. HRs adjusted for traditional cardiovascular risk factors for developing CVD (a composite of fatal and non-fatal coronary heart disease and stroke) were calculated.

Results During a median follow-up of 14.4 years, 1230 cardiovascular events occurred, of which 101 were in participants with clinical OA. Presence of radiographic OA at baseline was not related to future CVD (HR 0.99, 95% CI 0.86 to 1.15), neither was presence of clinical OA (HR 1.09, 95% CI 0.88 to 1.34). However, persons with increasing disability were more likely to suffer a cardiovascular event compared with non-disabled persons (HR 1.26, 95% CI 1.12 to 1.42); this was independent of the presence of OA.

Conclusions In this large population-based study, participants with OA were not at increased risk of CVD. The close relation between disability and osteoarthritis may explain previous findings. Further studies are required in order to clarify whether OA patients need more intensive treatment of their cardiovascular risk factors.

Keywords
  • cardiovascular disease
  • disability
  • population-based

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