Background Rheumatoid arthritis (RA) is associated with increased morbidity and mortality related to cardiovascular disease (CVD). Physical exercise (PE) is related with significant beneficial effects on the CV system; however, in patients with RA few studies demonstrate that PE is beneficial for functional prognosis or surrogate markers of CVD in RA.
Objectives To determine the effect of PE and hours of weekly physical activity on subclinical CVD markers in patients with RA.
Methods The study was developed over a period of two years. Patients were asked, by clinical interview, for regular PE practice (minimum three times per week, at least 30'), and the time spent walking daily in their normal duties was recorded. Demographic and clinical variables (age, gender, body mass index (BMI), duration of RA, smoking, hypertension (HT), dislypidemia (DL), atherogenic index (AI)) were determined. History of cardiovascular events (ischemic heart disease or stroke), diabetes mellitus (DM), or severe chronic renal disease (defined by a glomerular filtration rate <60) were considered exclusion criteria. Vascular damage was estimated by measuring systolic blood pressure (SBP) and pulse wave velocity (PWV), and a second determination was performed in a period of a year in 65 patients. PWV determination was performed by a validated device called MobilOGraph®. Patients were classified as having high CVR if the PWV> =10m/s. Intima media thickness (IMT) and the presence of atheromatous plaques were determined by ultrasound in the extracranial carotideal tree in accordance with Mannheim's consensus. Ultrasound examination was performed with an ultrasound Esaote MyLab xv70 with linear probe (7-12mHz) and an automated program that IMT measured by radio frequency (“Quality intima media Thickness in Real-time, QIMT”). The SPSS 17.0 program for descriptive statistics was used to analyze the data.
Results We evaluated 181 consecutive patients with RA without history of high CV risk. 77.9% of patients were female, with mean age of 58.77±13,06 years, mean BMI of 27.13±4,73; 18.4% were obese (IMC≥30). Other parameters were: average duration of 13,62±10,51 years-disease, 29.8% smokers, 30.9% HT, 42.5% DL, and average AI was 3,84±1,01. Additionally, average cIMT was 722±149,29mm, 12.7% had pathological cIMT (>0.9mm), 42% had plaques, and 26.1% had pathological PWV (average of 8,53±2,14m/s). There were observed differences in markers of vascular damage (PWV, cIMT, central and peripheral SBP) and clinical variables (age, BMI, AI) related with PE, although it did not reach statistical significance. PWV monitoring was performed in 65 patients for whom no association with PE practice and daily exercise was observed.
Conclusions The PE did not demonstrate effect on surrogate markers of cardiovascular risk or clinical aspects in our RA population.
Disclosure of Interest None declared