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, the PWV increases with age in healthy people. Improvements in parameters that determine vascular damage (PWV included) have been observed in patients with RA, after therapeutic intervention, but PWV's progression has not been studied in the daily clinical practice.
Objectives To determine changes of PWV in patients with RA and factors related to these changes, in usual clinical practice conditions.
Methods Among a cohort of 237 patients with RA who had been investigated for the existence of subclinical vascular disease by measurement of PWV, 90 of them were reassessed 12 months later. Patients diagnosed of high CV risk were excluded (history of CV events, renal failure and/or diabetes). Demographic data was registered (gender, age, BMI), as well as clinical and laboratory data of the disease (FR, anti-CCP, accumulated RPC, duration of the disease, total cholesterol and HDL), and the presence of cardiovascular risk (hypertension (HT), dyslipidemia (DL), smoking). The atherogenic index (AI) was calculated (total cholesterol/HDL), and the modified SCORE according to EULAR recommendations, was estimated. Patients were classified as high CV risk if PWV ≥10m/s. The SPSS 17.0 program was used for the descriptive statistic.
Results A total of 70 patients were assessed, of which 74,3% were women, 20% smokers, with a mean BMI of 27,89±4,85. 54,3% and 62,9% had anti-CCP and positive RF, respectively. 31,4% were HT, and 51,4% DL. Vascular damage was seen in 32,4% (VOP≥10m/s). There was a statistically significant difference (0,07-0,32) between mean PWV within a year. PWV mean within a year showed an association with modified SCORE (p 0,048), and a moderate correlation was observed between PWV and systolic blood pressure (SBP) (43,7%). The logistic regression determined a dependence between PWV and SBP [b (0,07-0,021), R2 0,191], controlled by the duration of RA, 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 Just as in general population, in patients with RA the PWV changes over time, related with SBP, but not with the duration of RA. An association with other classic CV risk variables was observed, but did not show statistical significance, so more determinations need to be done throughout the years to establish the relationship between RA, classic CV risk factors and vascular damage progression determined by PWV.
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Disclosure of Interest None declared