Rheumatoid arthritis is a common problem causing joint inflammation, pain, stiffness, and swelling. Rheumatoid arthritis is a chronic autoimmune disease, and although there is no cure early intervention can improve a patient’s quality of life. But rheumatoid arthritis doesn’t only affect the joints – in fact, a previous study found that individuals diagnosed with rheumatoid arthritis have double the risk of a heart attack and an increased risk of heart-related complications.
The condition is known as diastolic dysfunction, which makes the lower chambers of the heart stiff. Diastolic dysfunction also impairs the ability of the ventricles to fill with blood, which can contribute to heart failure. The findings were derived from three studies.
Dr. Hilal Maradit Kremers, lead researcher in one of the studies, said, “Rheumatoid arthritis patients not only have more heart attacks and heart failures, but they also have worse prognosis once they have a cardiovascular event.”
Kremers’ team followed 38 rheumatoid arthritis patients who also suffered a heart attack. These patients were compared to heart attack patients without rheumatoid arthritis. The researchers found that rheumatoid arthritis patients had a 45 percent greater risk of heart failure and heart attack, compared to the patients without rheumatoid arthritis. Furthermore, rheumatoid arthritis patients had a 75 percent higher risk of death.
The second study was led by Marie Gunnarsson who found that the risk of a heart attack in rheumatoid arthritis patients doubled within the first 10 years of diagnosis. Gunnarsson explained, “The fact that there is no increased risk prior to rheumatoid arthritis diagnosis suggests that there is something in the rheumatoid arthritis disease itself, such as inflammatory processes that lead to this increased risk. Measures to bring down inflammation in rheumatoid arthritis might, thus, be beneficial also from a cardiovascular prevention point of view in this population.”
The last study was carried out by Dr. Kimberly Liang who found that diastolic dysfunction was higher among rheumatoid arthritis patients, which could explain the heightened risk of a heart attack among these patients. Liang explained, “Diastolic dysfunction occurred in 38.9 percent, compared to 28.8 percent in the non-rheumatoid arthritis group. We also found that patients in the rheumatoid arthritis group had higher average pulmonary arterial pressure, which is high blood pressure in the lungs and the right side of the heart. This is consistent with the impaired filling of the heart seen in diastolic dysfunction.”
Dr. John Hardin, chief science officer at the Arthritis Foundation, said these studies highlight the role of inflammation in cardiovascular disease. Furthermore, he noted that some rheumatoid arthritis drugs can increase the risk of cardiovascular problems, too. “For example, Enbrel (etanercept) can, in fact, in some people, potentiate heart failure, which can be a complication of myocardial infarction,” he said.
Rheumatoid arthritis patients are advised to pay closer attention to their heart disease risk factors, such as body weight, cholesterol, blood sugar, and blood pressure, as well as partake in healthy lifestyle habits as mentioned above.