A recent Mayo Clinic study indicates that the heart disease risk assessment tools conventionally used by physicians may underestimate the cardiovascular disease danger faced by rheumatoid arthritis (RA) patients. According to the Rochester, Minn-based clinic’s study, many cardiovascular disease risk assessment methods do not factor in the key role inflammation plays in heightening risk of heart disease in RA patients.

Eric Matteson, MD, chairman of Mayo Clinic’s rheumatology division, notes that, “The study emphasizes that patients with rheumatoid arthritis are at higher risk for heart disease, and that conventional predictors of risk are not adequate for estimating this risk.” 

During the study, researchers reportedly observed 525 patients who were more than 30 years of age, and diagnosed with RA between the years 1988 and 2007 and with no previous history of cardiovascular disease. According to researchers, the study used medical records from the national Institutes of Health-funded Rochester Epidemiology Project. Researchers used the Framingham and Reynolds risk scores to measure study participants’ 10-year risk of developing cardiovascular disease. The study notes that the mean follow-up period was 8 years and that 84 patients developed cardiovascular disease during that time. 

The results suggest that the observed heart disease risk was twice as high among women and 65% higher in men than that Framingham score predicted. The Reynolds tool also exhibited similar shortcomings, researchers say.

The results also indicate that patients aged 75 years and older exhibited three times the risk of cardiovascular disease than the Framingham score predicted. Researchers add that patients with positive rheumatoid factor exhibited more heart disease events than the risk scores predicted.

Ongoing research is being conducted to pinpoint how inflammation leads to increased cardiovascular disease in RA patients and what treatments for RA may reduce this risk, Matteson says. “Further work must also evaluate just how patients with rheumatoid arthritis should be managed to detect and reduce their risk for cardiovascular disease,” Matteson notes.

Source: Mayo Clinic