Study highlights the need to improve cardiovascular preventive services in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is known to increase the risk of cardiovascular disease (CVD) regardless of traditional CVD risk factors, and the risk level is comparable to that of diabetes mellitus. According to a contemporary survey published in Rheumatic and Musculoskeletal Diseases Open, individuals with RA as their only CVD risk factor were less likely to undergo screenings, despite having an equivalent-to-higher risk to those with traditional CVD risk factors. 

Dr. Montes and colleagues included 1614 RA patients and 1599 non-RA comparators in the study. The study revealed that patients with RA were more likely to undergo diabetes and hypertension screenings than those without RA. However, hyperlipidemia screening rates were similar between the two groups. Interestingly, RA patients with no other CVD risk factors were less likely to undergo diabetes and hyperlipidemia screenings compared to non-RA patients with only one CVD risk factor. Hypertension screening was similar in both groups. The study concludes that although RA patients undergo CVD preventive screenings at rates comparable to the general population, those with RA as their sole CVD risk factor are less likely to undergo screenings, despite having an equivalent-to-higher risk than traditional CVD risk factors. 

It is important to focus on enhancing and sustaining the quality of life of RA patients, similar to managing other chronic conditions. Achieving this objective necessitates effective disease control and early detection of potential risk factors for preventable conditions, such as CVD. Studies indicate that patients with RA and comorbid CVD face significantly higher follow-up costs compared to those with RA alone. Regular screenings for hypertension, hyperlipidemia, and diabetes through blood pressure measurements, lipoprotein profiles, and fasting blood glucose tests are recommended. Adhering to these screening schedules can not only improve patients’ quality of life but also prove to be cost-effective, considering the elevated risk of CVD associated with RA. 

The survey provides an overview of utilization of preventive services for CVD among patients with RA. While there has been some progress in the overall utilization of preventive services for CVD, the screening for CVD risk factors appears to be less comprehensive in patients with RA who have only one risk factor. This also underscores the importance of increasing awareness among patients with RA regarding the significance of cardiovascular preventive services. Future research could explore the specific barriers or challenges contributing to the suboptimal screening rates in this subgroup of RA patients with singular CVD risk factors. 

References 

  1. Montes D, Hulshizer CA, Myasoedova E, Davis JM, Hanson AC, Duarte-Garcia A, et al. Utilisation of cardiovascular preventive services in a rheumatoid arthritis population-based cohort. RMD Open. 2023 Nov;9(4):e003318. 
  2. Joyce AT, Smith P, Khandker R, Melin JM, Singh A. Hidden Cost of Rheumatoid Arthritis (RA): Estimating Cost of Comorbid Cardiovascular Disease and Depression Among Patients with RA. The Journal of Rheumatology. 2009 Apr 1;36(4):743–52.  
  3. Kvien TK, Balsa A, Betteridge N, Buch MH, Durez P, Favalli EG, et al. Considerations for improving quality of care of patients with rheumatoid arthritis and associated comorbidities. RMD Open. 2020 Jul 18;6(2):e001211.  
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