Objectives: Rheumatoid arthritis (RA) patients are at increased risk for cardiovascular disease (CVD), which is even more pronounced in hypothyroid RA patients. An unfavourable cardiovascular risk profile conferred by a higher prevalence of metabolic syndrome (MetS) and a higher Framingham risk score might explain this amplified cardiovascular morbidity. Hence, this study compared firstly, MetS (features) and, secondly, the Framingham 10-year CVD risk in RA patients with hypothyroidism compared to euthyroid RA patients.
Methods: RA patients participating in the CARRÉ investigation were divided in two groups: hypothyroid and euthyroid RA patients. MetS according to the NCEP ATIII-criteria and the Framingham risk score were compared between hypothyroid and non hypothyroid CVD event-free RA patients.
Results: In total, 257 RA patients were included: 236 RA (91.8%) and 21 hypothyroid RA (8.2%), respectively. The prevalence of MetS was significantly higher in hypothyroid RA patients (43%) compared to RA patients (20%). Moreover, female hypothyroid RA patients had a higher, Framingham risk score compared to euthyroid RA patients. With RA patients as reference category, the age and gender adjusted prevalence OR for MetS was 3.5 (95%-CI: 1.3 – 9.1) in hypothyroid RA.
Conclusions: Hypothyroid RA patients, particularly female patients, have a more unfavourable cardiovascular risk profile, reflected by increased prevalence of MetS and higher Framingham score, than euthyroid RA patients, suggesting a higher need for cardiovascular risk management in these patients to prevent future CVD events.