Background Rheumatoid arthritis (RA) is associated with a higher risk of having cardiovascular (CV) disease. The measurement of arterial stiffness through pulse wave velocity (PWV) reflects early stages of CV disease. Physiologically, arterial stiffness increases with age in healthy people. Improvements in parameters that determine vascular damage (PWV included) have been observed in patients with RA following therapeutic intervention ; however, PWV's natural progression has not been studied in the daily clinical practice.
Objectives To determine PWV changes and related factors in patients with RA in usual clinical practice conditions.
Methods Out of a cohort of 237 patients with RA, all of whom had been investigated for the existence of subclinical vascular disease through PWV, 90 were reassessed twelve months later. Patients with high CV risk were excluded (history of CV events, renal failure and/or diabetes). The following parameters were registered: Demographic data (gender, age, BMI), clinical and laboratory data (RF, anti-CCP, accumulated CRP, duration of the disease, total cholesterol and HDL), and traditional CV risk factors (hypertension (HT), dyslipidemia (DL), smoking). The atherogenic index (AI) was calculated (total cholesterol/HDL), and the modified SCORE was estimated according to EULAR recommendations . Patients were classified as high CV risk when having a PWV ≥10m/s . The SPSS 17.0 program was used for the statistics.
Results A total of 70 patients were assessed: 74, 3% women, 20% smokers, mean BMI:27, 89±4,85. 54, 3% and 62, 9% had anti-CCP and positive RF, respectively. 31, 4% were HT, and 51, 4% had DL. Increased arterial stiffness (PWV≥10m/s) was seen in 32, 4%. There was a statistically significant difference (0, 07-0, 32) between baseline and one-year mean PWV. The mean change in PWV showed an association with modified SCORE (p 0, 048), and a moderate correlation with systolic blood pressure (SBP) (43, 7%). The lineal regression showed a dependence between PWV and SBP [b (0,07-0,021), R2 0,191], controlled for RA duration, QIMT, IA, age and BMI. The other studied variables (gender, HT, DL, smoking, RF and anti-CCP) showed differences between groups, but did not reach statistical significance.
Conclusions In patients with RA, just as in the general population, PWV increases over time in relation to SBP, but not with the duration of the disease. An association with other classic CV risk variables was observed, but did not show statistical significance. More studies are needed to establish a relation between RA, classic CV risk factors and vascular damage progression determined by PWV.
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Disclosure of Interest None declared