Background The cardiovascular risk of individuals with spondyloarthritis (SpA) is increased (1) compared to the general population of the same age and sex. Early identification of cardiovascular risk factors and ongoing monitoring of these factors are mandatory to reduce the excess cardiovascular risk.
Objectives Considering the scientific evidence about the effectiveness of an educational nursing intervention in these patients (2), we pursue the aim of designing a protocol for nursing management of cardiovascular risk in patients with SpA (particularly ankylosing spondylitis and psoriatic arthritis).
Methods Prospective study of a consecutive sample of patients, who are part or the follow up SpA Rheumatology cohort of a tertiary level hospital, once signed informed consent.
In medical visit, an assessment of disease activity with validated questionnaires and treatment monitoring is performed. Furthermore, carotid ultrasound for detection of subclinical atherosclerosis is performed.
Results The individual educational intervention begins with a closed directed interview. Subsequently, vital signs, the ABI (Ankle-brachial Index) is performed for all patients who meet the screening criteria, according to the American Heart Association, cardiovascular risk according to the SCORE charts validated for Spain, Classic Framingham and REGICOR are measured.
The three pillars on which the Nursing Intervention is carried out are: smoking, exercise and eating habits (3).
Smoking habits: Fagerstrom Test for the measurement of the level of nicotine dependence. Tobacco education, motivation to quit and referral to pulmonology Smoking Cessation, when the subject is willing to quit.
Correlation of physical activity level with BMI (Body Mass Index) and lipid profile to establish a pattern of individualized physical activity depending on local resources.
Eating Habits: Individual eating advice, encouragement of Mediterranean diet and check on levels of salt and saturated fats.
After the consultation, we set realistic achievable goals and assessing their fulfilment by telephone follow-up visits every 6 months and a face to face interview every two years, where repeat measurements to establish a comparison.
Conclusions Thanks to our study, we will obtain scientific evidence on the effectiveness of the educational intervention on health and on the influence over the correction of modifiable cardiovascular risk factors.
We hope to highlight the key role of nursing in the management of these patients and that these findings are indicative of the development of evidence-based practice in nurse led care.
Also, the results, and their effectiveness will duly reported.
Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT. Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum. 2004;34(3):585-92.
Garcia-Diaz S, Corominas H. Nurse management of cardiovascular risk factors in rheumatoid arthritis. Br J Nurs. 2013;22(14):813-7.
Lobos JM, Royo-Bordonada MA, Brotons C, Alvarez-Sala L, Armario P, Maiques A, et al. [European Guidelines on Cardiovascular Disease Prevention in Clinical Practice: CEIPC 2008 Spanish adaptation]. Rev Esp Salud Publica. 2008;82(6):581-616.
Disclosure of Interest None declared