In rheumatoid arthritis, standard heart disease risk tools underrate danger!
Patients suffering from rheumatoid arthritis, or RA for short, are at higher risk for heart disease. Among experts that’s a matter of common knowledge (fortunately and increasingly that is basic knowledge among patients, too!).
Watch out, doctors! – In elderly rheumatoid arthritis patients commonly used heart disease risk assessment tools regularly fail, according to a current study. – © Robbie Ribeiro
On a less positive note, commonly used heart disease risk assessment tools seem to be inadequate for estimating the risk of cardiovascular disease danger faced by RA patients. That is what a brand-new study found.
In this blog article I summarise the main results of the research done at Mayo Clinic in Rochester, Minnesota (USA). The study is entitled Usefulness of Risk Scores to Estimate the Risk of Cardiovascular Disease in Patients With Rheumatoid Arthritis, and it has been published online on 20th April 2012 in The American Journal of Cardiology.
Heart disease risk in RA: More accurate assessment tools needed
The study estimated the accuracy of the Framingham and Reynolds risk scores, two tools commonly used by physicians for assessing patients’ heart disease danger. The scientists found that these two assessment tools substantially underrated cardiovascular disease danger both in women and men suffering from rheumatoid arthritis. In particular, that happens in older patients. Interestingly enough, it also happens in people who test positive for rheumatoid factors. (more…)
The long Arm of the Dendritic Cells: The Link between Atherosclerosis and Autoimmune Diseases
Inflammation has been closely linked to autoimmunogenic processes in atherosclerosis. In fact, patients who are suffering from an autoimmune disease have an increased incidence of “hardening of the arteries”, concretely atherosclerosis (the spelling “arteriosclerosis” is also common). In the case of rheumatoid arthritis (RA) the patients have a 30 to 60% higher risk of suffering a heart attack or stroke!
It is an accepted fact: Rheumatoid arthritis patients have a higher risk of suffering a heart attack or stroke. But where is the connection between the two types of disease?
pDCs: the link between atherosclerosis and autoimmunity
Now clinical researchers at Munich Ludwig-Maximilians-University (LMU) have uncovered a mechanism which establishes a causal link between the two types of disease. The immunological process may help to explain the link between autoimmunity and atherosclerosis.
The mechanism described is provided by a specific class of immune cells called plasmacytoid dendritic cells (pDCs). The pDCs respond to DNA released from damaged and dying cells by secreting interferon proteins. The research, which is done in collaboration with scientists from Rudolf Virchow Center at Wuerzburg University, shows that stimulation of pDCs by a specific DNA-protein complex contributes to the progression of atherosclerosis. These findings may have implications for new strategies for the treatment of a whole spectrum of conditions that are associated with chronic inflammatory reactions. (more…)
Rheumatism affects more than just the joints: the heart and circulatory system are also at risk!The knowledge gradually sinks in, even for patients: inflammatory rheumatic diseases like rheumatoid arthritis (RA) not only damage the joints, but also the blood vessels. Patients with rheumatism thus have an increased risk of suffering a heart attack or stroke.
Why is this the case? Rheumatoid arthritis (RA) not only causes inflammation of the musculoskeletal system; it also affects the walls of blood vessels. In addition, RA patients have an increased incidence of hardening of the arteries, arteriosclerosis. “These patients have a 30 to 60 % higher risk of suffering a heart attack or stroke.”
These figures are given by Professor Dr. med. Jürgen Braun, Medical Director of the Ruhr Centre for Rheumatism in Herne, Germany (Rheumazentrum Ruhrgebiet). (These figures and excerpts, and those that follow, were published by the German Society of Rheumatology- Deutsche Gesellschaft für Rheumatologie, DGRh, in the run-up to the 38th Congress of the DGRh (38. Kongress der Deutschen Gesellschaft für Rheumatologie e.V.), which is currently underway in Hamburg.) Prof. Jürgen Braun adds, “The danger increases further when patients have elevated lipid levels, high blood pressure or diabetes, or are overweight.” (more…)