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Hand osteoarthritis in relation to mortality and incidence of cardiovascular disease: data from the Framingham Heart Study
  1. Ida K Haugen1,
  2. Vasan S Ramachandran2,3,
  3. Devyani Misra4,
  4. Tuhina Neogi4,
  5. Jingbo Niu4,
  6. Tianzhong Yang4,
  7. Yuqing Zhang4,
  8. David T Felson4
  1. 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, USA
  3. 3Department of Cardiology, Boston University School of Medicine, Boston, Massachusetts, USA
  4. 4Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr I K Haugen, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vinderen, Oslo 0319, Norway; haugen_ida{at}


Objectives To study whether hand osteoarthritis (OA) is associated with increased mortality and cardiovascular events in a large community based cohort (Framingham Heart Study) in which OA, mortality and cardiovascular events have been carefully assessed.

Methods We examined whether symptomatic (≥1 joint(s) with radiographic OA and pain in the same joint) and radiographic hand OA (≥1 joint(s) with radiographic OA without pain) were associated with mortality and incident cardiovascular events (coronary heart disease, congestive heart failure and/or atherothrombotic brain infarction) using Cox proportional hazards models. In the adjusted models, we included possible confounding factors from baseline (eg, metabolic factors, medication use, smoking/alcohol). We also adjusted for the number of painful joints in the lower limb and physical inactivity.

Results We evaluated 1348 participants (53.8% women) with mean (SD) age of 62.2 (8.2) years, of whom 540 (40.1%) and 186 (13.8%) had radiographic and symptomatic hand OA, respectively. There was no association between hand OA and mortality. Although there was no significant relation to incident cardiovascular events overall or a relation of radiographic hand OA with events, we found a significant association between symptomatic hand OA and incident coronary heart disease (myocardial infarction/coronary insufficiency syndrome) (HR 2.26, 95% CI 1.22 to 4.18). The association remained after additional adjustment for pain in the lower limb or physical inactivity.

Conclusions Symptomatic hand OA, but not radiographic hand OA, was associated with an increased risk of coronary heart disease events. The results suggest an effect of pain, which may be a possible marker of inflammation.

  • Osteoarthritis
  • Epidemiology
  • Hand Osteoarthritis
  • Cardiovascular Disease

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