Article Text

PDF
AB0373 Arterial Stiffness Increases Over Time in Patients with Rheumatoid Arthritis. Related Factors
  1. M. Robustillo Villarino1,
  2. E. Rodilla Sala2,
  3. F. Gil Latorre1,
  4. M.D. Ybañez Garcia1,
  5. M.A. Martínez Ferrer1,
  6. È. Valls Pascual1,
  7. E. Vicens Bernabeu1,
  8. C. Vergara Dangond1,
  9. G. Alber Espí1,
  10. J.J. Alegre Sancho1
  1. 1Rheumatology, Hospital universitario doctor Peset, Valencia
  2. 2Internal Medicine, Hospital universitario Sagunto, Sagunto, Spain

Abstract

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 [1]; 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 [1]. Patients were classified as high CV risk when having a PWV ≥10m/s [2]. 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.

References

  1. Peters MJ, 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;69:325–31.

  2. Mancia G, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013 Jul;31:1281-357.

  3. Mäki-Petäjä KM, et al. Circulation. 2006 Sep 12;114:1185-92.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.