RA and Heart Disease

What does cardiovascular disease look like in rheumatoid arthritis?

The chronic inflammation which damages joints also takes its toll on the heart and arteries. The doctors at Johns Hopkins provide a summary of recent studies focused on RA and heart disease. Compared to the general population, rheumatoid arthritis patients have a significantly increased risk of heart attack and stroke and a shorter life expectancy.

• 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.

Accumulating immune system cells (caused by chronic inflammation) 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.

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Rheumatoid Arthritis and Cardiovascular Disease