Background Rheumatoid arthritis (RA) associates with accelerated atherosclerosis and high cardiovascular mortality. Cardiovascular risk management in RA comorbid with HT pts is do not fully reflected by traditional risk scales, thus additional factors searching is required.
Objectives We aimed to estimate the subclinical manifestations of atherosclerosis in RA females comorbid with HT and its relationship with traditional, additional risk factors.
Methods The study included 112 RA females with comorbid HT (mean age of 54 [50,3; 61,5] years) and 105 RA females without HT (control group). All pts received stable therapy of RA more than 6 months. Pts with coronary artery disease were excluded. The risk of fatal cardiovascular disease was calculated using m SCORE (EULAR 2010). RA disese activity was measured using DAS28 scale. Carotid ultrasound with stiffness indexes detection and endothelial-dependent flow mediated vasodilatation (EDVD) by Celermajer method were performed. The levels of adiponectin, insulin were measured using ELISA kit test, insulin resistance was estimated using HOMA2 index.
Results Subclinical manifestations of atherosclerosis were established in 88 (78.6%) RA females with HT and 55 (52,4%) control group pts. The majority of main group pts have atherosclerotic plaques - 62 (55.4%), unstable plaques had 26 (23.2%) pts. While only 33 (29,5%) patients were high and very high cardiovascular risk assessed by mSCORE. In compare, 35 (33,3%) control group pts have atherosclerotic plaques, unstable plaques had only 14 (13.3%) control pts (p<0.05). The presence of atherosclerotic plaques in RA females with HT was associated with age, RA disease activity, endothelial dysfunction, carotid stiffness, LDL cholesterol level, insulin resistance, adiponectin level, duration of steroid therapy. AUROC index for adiponectin and HOMA2 were 0.83 (95% CI 0.74–0.95; p<0.05 and 0.75 (95% CI 0.68–0.91; p<0.05 respectively, that indicate a good quality of diagnostic models.
Conclusions RA females with comorbid HT are characterized by higher frequency of subclinical atherosclerosis with unstable atherosclerotic plaques in compare with controls. Endothelial function, insulin resistance, adiponectin level, carotid stiffness determining may be useful additional tools for cardiovascular risk evaluating in this pts.
Disclosure of Interest None declared