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The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

BACKGROUND: Rheumatoid arthritis (RA) is known to increase the risk of cardiovascular (CV) disease. However, the individual impact of traditional CV risk factors in RA is unknown. OBJECTIVE: To assess the strength of the association between individual CV risk factors and rate of either myocardial in...

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Autores principales: Baghdadi, Leena R., Woodman, Richard J., Shanahan, E. Michael, Mangoni, Arduino A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331556/
https://www.ncbi.nlm.nih.gov/pubmed/25689371
http://dx.doi.org/10.1371/journal.pone.0117952
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author Baghdadi, Leena R.
Woodman, Richard J.
Shanahan, E. Michael
Mangoni, Arduino A.
author_facet Baghdadi, Leena R.
Woodman, Richard J.
Shanahan, E. Michael
Mangoni, Arduino A.
author_sort Baghdadi, Leena R.
collection PubMed
description BACKGROUND: Rheumatoid arthritis (RA) is known to increase the risk of cardiovascular (CV) disease. However, the individual impact of traditional CV risk factors in RA is unknown. OBJECTIVE: To assess the strength of the association between individual CV risk factors and rate of either myocardial infarction (MI), combined CV morbidity (MI, angina pectoris, heart failure, stroke, and peripheral arterial disease (PAD)) or CV mortality in RA patients. METHODS: RA studies reporting traditional CV risk factors [hypertension, type 2 diabetes (T2D), smoking, hypercholesterolaemia, obesity, and physical inactivity] as exposures and MI, CV morbidity (MI, angina, heart failure, stroke, and PAD combined) or CV mortality alone as outcomes were searched until March 2013 using MEDLINE, Scopus and Cochrane. Meta-analyses combined relative risk (RR) estimates from each study where either the RR and 95% confidence intervals or where raw counts were available. RESULTS: Ten studies reporting sufficient data for inclusion into meta-analyses were identified. Relevant data was available for each risk factor and MI and CV morbidity but no studies reported on CV mortality. Risk of MI increased in RA patients with hypertension (RR 1.84, 95% CI 1.38, 2.46) and T2D (RR 1.89, 95% CI 1.36, 2.63). CV morbidity increased with hypertension (RR 2.24, 95% CI 1.42, 3.06), T2D (RR 1.94, 95% CI 1.58, 2.30), smoking (RR 1.50, 95% CI 1.15, 1.84), hypercholesterolaemia (RR 1.73, 95% CI 1.03, 2.44) and obesity (RR 1.16, 95% CI 1.03, 1.29) but not with physical inactivity (RR 1.00, 95% CI 0.71, 1.29). CONCLUSION: Hypertension, T2D, smoking, hypercholesterolaemia and obesity increased CV risk in patients with RA. These results highlight the importance of managing CV risk factors in RA, similarly to non-RA patients.
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spelling pubmed-43315562015-02-24 The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis Baghdadi, Leena R. Woodman, Richard J. Shanahan, E. Michael Mangoni, Arduino A. PLoS One Research Article BACKGROUND: Rheumatoid arthritis (RA) is known to increase the risk of cardiovascular (CV) disease. However, the individual impact of traditional CV risk factors in RA is unknown. OBJECTIVE: To assess the strength of the association between individual CV risk factors and rate of either myocardial infarction (MI), combined CV morbidity (MI, angina pectoris, heart failure, stroke, and peripheral arterial disease (PAD)) or CV mortality in RA patients. METHODS: RA studies reporting traditional CV risk factors [hypertension, type 2 diabetes (T2D), smoking, hypercholesterolaemia, obesity, and physical inactivity] as exposures and MI, CV morbidity (MI, angina, heart failure, stroke, and PAD combined) or CV mortality alone as outcomes were searched until March 2013 using MEDLINE, Scopus and Cochrane. Meta-analyses combined relative risk (RR) estimates from each study where either the RR and 95% confidence intervals or where raw counts were available. RESULTS: Ten studies reporting sufficient data for inclusion into meta-analyses were identified. Relevant data was available for each risk factor and MI and CV morbidity but no studies reported on CV mortality. Risk of MI increased in RA patients with hypertension (RR 1.84, 95% CI 1.38, 2.46) and T2D (RR 1.89, 95% CI 1.36, 2.63). CV morbidity increased with hypertension (RR 2.24, 95% CI 1.42, 3.06), T2D (RR 1.94, 95% CI 1.58, 2.30), smoking (RR 1.50, 95% CI 1.15, 1.84), hypercholesterolaemia (RR 1.73, 95% CI 1.03, 2.44) and obesity (RR 1.16, 95% CI 1.03, 1.29) but not with physical inactivity (RR 1.00, 95% CI 0.71, 1.29). CONCLUSION: Hypertension, T2D, smoking, hypercholesterolaemia and obesity increased CV risk in patients with RA. These results highlight the importance of managing CV risk factors in RA, similarly to non-RA patients. Public Library of Science 2015-02-17 /pmc/articles/PMC4331556/ /pubmed/25689371 http://dx.doi.org/10.1371/journal.pone.0117952 Text en © 2015 Baghdadi et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Baghdadi, Leena R.
Woodman, Richard J.
Shanahan, E. Michael
Mangoni, Arduino A.
The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
title The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
title_full The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
title_fullStr The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
title_full_unstemmed The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
title_short The Impact of Traditional Cardiovascular Risk Factors on Cardiovascular Outcomes in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
title_sort impact of traditional cardiovascular risk factors on cardiovascular outcomes in patients with rheumatoid arthritis: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331556/
https://www.ncbi.nlm.nih.gov/pubmed/25689371
http://dx.doi.org/10.1371/journal.pone.0117952
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