Background Patients with rheumatoid arthritis (RA) suffer from increased mortality due to cardiovascular disease (CVD) (1). Aerobic capacity (VO₂ max) is inversely and strongly related to cardiovascular disease in the general population (2). RA patients have shown very low levels of VO₂ max compared to normative values of healthy adults (3), which may be of importance for the increased CVD incidence in RA.

Objectives To analyse the change of VO₂ max over time from disease onset and associated potential risk- and health factors in patients with RA.

Methods 25 patients (20 f/ 5 m), diagnosed with RA 1995–2002 were tested at disease onset (<12 months from symptom onset) and after a mean of 16.2 years. Applied measurements were: sub-maximal ergometer test for VO₂ max, functional ability, joint- and muscle function, self-efficacy, ESR, CRP, number of tender and swollen joints and patient's global health. At follow-up, the risk of CVD was measured as blood levels of lipids, insulin and glucose, Body mass index (BMI), waist circumference and body composition measured by Dual-energy X-ray absorbtiometry (DXA). Pulse wave analysis (PWA), was used to register early endothelial dysfunction, arterial stiffness and systolic blood pressure in aorta besides peripheral blood pressure. Carotid Intima-Media Thickness (IMT) was measured by ultrasonography. Additionally, Fatigue Severity Scale was used at follow-up.

Results All measures reflecting disease activity decreased significantly during the follow-up period. VO₂ max was (median (IQR)) 32.3 (14.2) ml O₂/kg x min at disease onset, and 33,2 (10.5) at follow-up (p>0.05). Aerobic capacity at inclusion was associated with follow-up values for age (r=-.469, p=.018), VO₂ max (r=.557, p=.004), BMI (r=-.401, p=.047), body weight (r=-.409, p=.043), waist circumference (r=-.498, p=.011) and periferal pulse pressure (r=-.415, p=.039). Variables at disease onset associated with VO₂ max at follow-up were VO₂ max (r=.557, p=.004) and self-efficacy for function, (r=.544, p=.029).

Conclusions In patients with RA followed for 16 years from disease onset, VO₂ max was maintained. High aerobic capacity at disease onset was associated with favourable measures of VO₂ max and body weight at follow-up. The variables at disease onset that best correlated with a high VO₂ max at follow-up were high VO₂ max and self-efficacy for function. Our results may be important for preventive strategies in RA.

1. Wallberg-Jonsson, S., et al. J Rheumatol 1997;24(3):445–451.

2. Kodama, S., et al. JAMA 2009;301(19):2024–2035.

3. Metsios, G.S., et al. Rheumatology (Oxford) 2015;54(12):2215–2220.

Disclosure of Interest None declared