Rheumatoid Arthritis and Your Heart

Johns Hopkins Health Alerts reports on the latest findings on the causes of rheumatoid arthritis, and how it can affect your heart, leading to increased risk of heart attack and stroke, and thus decreased life expectancy.

New York,March 18, 2008 -- In a recent issue of The Johns Hopkins arthritis Bulletin, Johns Hopkins specialists reported on the latest research regarding the link between rheumatoid arthritis and heart health.

With rheumatoid arthritis, the inflammation that damages joints also takes a toll on the heart. Johns Hopkins specialists offer bottom line advice on how to adopt a heart-healthy lifestyle to combat the effects of rheumatoid arthritis (Rheumatoid Arthritis) and its accompanying inflammation.

BEING HEART-SMART WITH RA
People with rheumatoid arthritis understandably focus on caring for their joints. But their most serious health risk involves their heart.

Compared to the general population, rheumatoid arthritis patients have a significantly increased risk of heart attack and stroke, and a shorter life expectancy.

RA AND YOUR HEART: THE RISKS
Here are some of the findings from recent studies about the link between rheumatoid arthritis and heart disease:

• Heart attacks are twice as common among women with rheumatoid arthritis as among those without the disease.

• Atherosclerosis ("hardening of the arteries") starts early and progresses more rapidly in people with rheumatoid arthritis.

• Carotid artery blockages (a risk factor for stroke) are three times more common in people with rheumatoid arthritis than in people without the disease (44% vs. 15%).

• Cardiovascular events, such as heart attack and stroke, occur about 10 years earlier in people with rheumatoid arthritis.

• Mortality is higher among rheumatoid arthritis patients after a first heart attack.

• Blood vessel damage is often already apparent at the time of rheumatoid arthritis diagnosis.

• Heart attacks in rheumatoid arthritis patients are more likely to be silent or to occur without the typical symptoms, and they more often result in sudden cardiac death.

• Congestive heart failure (weakening of the heart's pumping ability) is more common among people with rheumatoid arthritis.

Researchers have identified several links between rheumatoid arthritis and cardiovascular disease. Inflammation is believed to be the most important of these.

THE ROLE OF INFLAMMATION IN ATHEROSCLEROSIS
Cardiologists now understand that inflammation plays a crucial role in the onset of atherosclerosis. They believe that an injury to the inner lining of the arteries (the endothelium) triggers an immune response, sending immune system cells rushing to repair the damage.

THE EFFECTS OF CHRONIC INFLAMMATION ON YOUR ARTERIES
But in chronic inflammatory states such as rheumatoid arthritis, the immune response doesn't shut off after the injury heals. The accumulating immune system cells attract deposits of cholesterol, blood platelets, cellular debris, and calcium, which clump together to form plaque.

As plaque deposits grow, they restrict blood flow through the artery. If the plaque ruptures, clots can break away and travel to the heart or brain, where they may cause a heart attack or a stroke.

BOTTOM LINE ADVICE: WHAT CAN YOU DO TO STAY HEART-SMART EVEN IF YOU HAVE RHEUMATOID ARTHRITIS
The relationship between rheumatoid arthritis and the heart is complex, and rheumatologists still have a great deal to learn about how to reduce the risk of cardiovascular disease among people who have rheumatoid arthritis.

For now, it's important to do everything possible to reduce the traditional risk factors for heart disease and stroke:
smoking, obesity, a sedentary lifestyle, high blood pressure, high cholesterol, and diabetes.

Getting regular exercise and losing extra pounds (even a 5-10% weight reduction is beneficial) will help your joints as well as your heart. Monitor your blood pressure and have your cholesterol levels checked regularly.

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