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The presence of total knee or hip replacements due to osteoarthritis enhances the positive association between hand osteoarthritis and atherosclerosis in women: the AGES–Reykjavik study
  1. Helgi Jonsson1,
  2. Gudrun P Helgadottir2,
  3. Thor Aspelund2,3,
  4. Gudny Eiriksdottir3,
  5. Sigurdur Sigurdsson3,
  6. Kristin Siggeirsdottir3,
  7. Thorvaldur Ingvarsson4,
  8. Tamara B Harris5,
  9. Lenore Launer5,
  10. Vilmundur Gudnason2,3
  1. 1Landspitalinn University Hospital, University of Iceland, Reykjavik, Iceland
  2. 2University of Iceland, Reykjavik, Iceland
  3. 3Icelandic Heart Association, Kopavogur, Iceland
  4. 4Akureyri Central Hospital, Akureyri, Iceland
  5. 5National Institute on Aging, Bethesda, Maryland, USA
  1. Correspondence to Professor Helgi Jonsson, Landspitalinn University Hospital, University of Iceland, IS-108 Fossvogur, Reykjavik, Iceland; helgi{at}


Objective This study examines the relationship between total knee replacements (TKR), total hip replacements (THR) or replacements of either joint (total joint replacement; TJR) due to osteoarthritis and atherosclerosis in a large population-based study.

Methods The participants were 2195 men and 2975 women, mean age 76±6 years. The osteoarthritis data were analysed in relation to measures of atherosclerosis, including carotid artery intima media thickness and plaque severity (ultrasound), coronary and aortic calcifications (CT), cerebral white matter lesions (MRI) and a history of previous cardiac and cerebral events.

Results The prevalence of TKR was 223 (4.3%) and THR 316 (6.1%). The presence of TJR in women was associated with a non-significant trend towards increased carotid plaque severity, coronary calcifications and periventricular white matter hyperintensities (PVH) but not with a history of cardiac or cerebral events. No associations were seen in men. When TJR were grouped according to the presence or absence of hand osteoarthritis (HOA) there was a highly significant association in the order −TJR/−HOA < +TJR/−HOA < −TJR/+HOA < +TJR/+HOA, for carotid plaque severity, coronary calcifications and PVH.

Conclusion The presence of TJR did not show a significant independent association with atherosclerosis but enhanced the strength of the positive association between HOA and subclinical atherosclerosis in women.

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  • Funding The Age, Gene/Environment Susceptibility Reykjavik Study (AGES–Reykjavik) has been funded by NIH contract N01-AG-12100, the NIA Intramural Research Program, Hjartavernd (the Icelandic Heart Association) and the Althingi (the Icelandic Parliament), the Icelandic Osteoarthritis Fund and the University of Iceland Research Fund.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Icelandic National Bioethics Committee (VSN: 00-063) and the Data Protection Authority.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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