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Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives
  1. George D Kitas1,2,
  2. Sherine E Gabriel3
  1. 1Department of Rheumatology, Dudley Group of Hospitals NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands, UK
  2. 2Arthritis Research UK Epidemiology Unit, Manchester University, Manchester, UK
  3. 3Department of Health Sciences Research, Division of Epidemiology; Department of Medicine, Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Professor George D Kitas, Dudley Group of Hospitals NHS Foundation Trust (Teaching), Clinical Research Unit - North Block, Russells Hall Hospital, Dudley DY1 2HQ, UK; gd.kitas{at}dgoh.nhs.uk or g.d.kitas{at}bham.ac.uk

Abstract

Rheumatoid arthritis is associated with an increased risk for cardiovascular events, such as myocardial infarction and stroke. Epidemiological evidence suggests that classic cardiovascular risk factors, such as hypertension, dyslipidaemia, insulin resistance and body composition alterations are important but not sufficient to explain all of the excess risk. High-grade systemic inflammation and its interplay with classic risk factors may also contribute. Some associations between classic risk factors and cardiovascular risk in people with rheumatoid arthritis appear counterintuitive but may be explained on the basis of biological alterations. More research is necessary to uncover the exact mechanisms responsible for this phenomenon, develop accurate systems used to identify patients at high risk, design and assess prevention strategies specific to this population of patients.

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Footnotes

  • Funding Arthritis Research, UK, the British Heart Foundation, the Medical Research Council and the National Institutes of Health, National Institute of Arthritis and Musculoskeletal Diseases.

  • Provenance and peer review Commissioned; externally peer reviewed.

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