RHEUMATOID ARTHRITIS AND HEART DISEASE
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is one of the most common forms of arthritis. It affects more than 2 million Americans. RA involves swelling of the lining of the joints causing pain, stiffness, warmth, redness and difficult movement. It also can affect internal organs. A person with RA may have a fever, a feeling of tiredness and a decrease in the number of red blood cells (anemia). There is probably no other disease that causes body tissues to suffer such prolonged and sustained inflammation. Sometimes rheumatoid nodules (lumps of tissue under the skin) form close to the joints. Joints commonly affected include the neck, shoulders, elbows, hips, knees and ankles.
Is there a link between arthritis and heart disease?
According to studies published in the journals of Circulation, Arthritis and Rheumatism, Journal of Rheumatology and Arthritis Research and Therapy, people with rheumatoid arthritis have a greater risk of heart disease than the general population. During the two years before diagnosis of RA, persons with this disease were three times more likely to have had a heart attack requiring hospitalization and five times more likely to have an unrecognized heart attack. After diagnosis, arthritis patients were twice as likely to experience unrecognized heart attacks and sudden cardiac death. Persons with arthritis are often less likely to have a history of chest pain, possibly due to pain relieving medications being used to treat their arthritis. A significant increase in stroke has not been found.
What causes the increased risk of heart disease in persons with arthritis?
The exact cause is not known. Researchers have found that an increase in traditional risk factors such as high blood pressure, increased cholesterol, and obesity were not enough to explain the increased number of cardiac events seen in their studies. Swelling (inflammation) that is associated with rheumatoid arthritis also may promote heart disease. The increased risk is most likely due to many factors combined.
What are the signs and symptoms of a heart attack?
Some heart attacks are sudden and intense – the “movie heart attack” – and no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected are not sure what's wrong and wait too long before getting help. Here are warning signs that can mean a heart attack is happening:
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath. This may occur before, with or without chest discomfort.
Other signs. These may include breaking out in a cold sweat, or experiencing nausea or lightheadedness.
Learn the signs. Even if you're not sure it's a heart attack, have it checked out. Minutes matter. Fast action can save lives — maybe your own. Do not wait more than five minutes to call 911.
Can a person with rheumatoid arthritis decrease their risks of heart disease?
Persons with rheumatoid arthritis should be screened and treated for cardiac risk factors including high cholesterol. It is important that persons with arthritis recognize the traditional risk factors for heart disease and the other risk factors that are associated with the arthritis and seek medical care.
There are many things that can be done to reduce the risk for heart disease such as: not smoking, eating a heart healthy diet, getting plenty of regular physical activity, keeping weight under control, getting regular medical checkups, managing stress, and controlling blood pressure and cholesterol.
American Heart Association
American College of Rheumatology
Centers for Disease Control and Prevention
National Heart, Lung, and Blood Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Stroke Association
Illinois Department of Public Health