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Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation

BACKGROUND: Ankylosing spondylitis (AS) is an inflammatory disease with documented elevated cardiovascular (CV) risk due to systemic inflammation and a higher prevalence of CV risk factors. CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients. W...

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Autores principales: Heslinga, Sjoerd C, Van den Oever, Inge A, Van Sijl, Alper M, Peters, Mike J, Van der Horst-Bruinsma, Irene E, Smulders, Yvo M, Nurmohamed, Michael T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404047/
https://www.ncbi.nlm.nih.gov/pubmed/25886634
http://dx.doi.org/10.1186/s12891-015-0532-3
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author Heslinga, Sjoerd C
Van den Oever, Inge A
Van Sijl, Alper M
Peters, Mike J
Van der Horst-Bruinsma, Irene E
Smulders, Yvo M
Nurmohamed, Michael T
author_facet Heslinga, Sjoerd C
Van den Oever, Inge A
Van Sijl, Alper M
Peters, Mike J
Van der Horst-Bruinsma, Irene E
Smulders, Yvo M
Nurmohamed, Michael T
author_sort Heslinga, Sjoerd C
collection PubMed
description BACKGROUND: Ankylosing spondylitis (AS) is an inflammatory disease with documented elevated cardiovascular (CV) risk due to systemic inflammation and a higher prevalence of CV risk factors. CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients. We assessed CV risk and evaluated guideline adherence according to the Dutch CV-RM guideline. METHODS: This study was conducted with a cohort of consecutive AS patients eligible for treatment with a tumor necrosis factor (TNF) -α inhibitor. Data from the Dutch National Institute for Public Health and Environment was used to compare the prevalence of CV risk factors in AS patients with the Dutch background population. RESULTS: In total, 254 consecutive AS patients were included. The prevalences of hypertension (41% vs 31%) and smoking (43% vs 27%) were substantially higher in AS patients as compared to the general Dutch background population. Of 138 AS patients older than 40 years the 10-years CV risk could be calculated. Fifty-one of these 138 patients (37%) had an indication for CV risk treatment. CV risk treatment was initiated in 42 of the 51 (82%), however, in only 12 of the 51 (24%) patients treatment targets for either hypertension or hypercholesterolemia were reached. CONCLUSION: The increased rates of hypertension and smoking illustrate the importance of CV-RM in AS patients. Although the majority of all AS patients eligible for CV-RM received CV risk medication, CV-RM remains a challenge for treating physicians, as treatment targets were not achieved in three-quarter of the eligible patients.
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spelling pubmed-44040472015-04-21 Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation Heslinga, Sjoerd C Van den Oever, Inge A Van Sijl, Alper M Peters, Mike J Van der Horst-Bruinsma, Irene E Smulders, Yvo M Nurmohamed, Michael T BMC Musculoskelet Disord Research Article BACKGROUND: Ankylosing spondylitis (AS) is an inflammatory disease with documented elevated cardiovascular (CV) risk due to systemic inflammation and a higher prevalence of CV risk factors. CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients. We assessed CV risk and evaluated guideline adherence according to the Dutch CV-RM guideline. METHODS: This study was conducted with a cohort of consecutive AS patients eligible for treatment with a tumor necrosis factor (TNF) -α inhibitor. Data from the Dutch National Institute for Public Health and Environment was used to compare the prevalence of CV risk factors in AS patients with the Dutch background population. RESULTS: In total, 254 consecutive AS patients were included. The prevalences of hypertension (41% vs 31%) and smoking (43% vs 27%) were substantially higher in AS patients as compared to the general Dutch background population. Of 138 AS patients older than 40 years the 10-years CV risk could be calculated. Fifty-one of these 138 patients (37%) had an indication for CV risk treatment. CV risk treatment was initiated in 42 of the 51 (82%), however, in only 12 of the 51 (24%) patients treatment targets for either hypertension or hypercholesterolemia were reached. CONCLUSION: The increased rates of hypertension and smoking illustrate the importance of CV-RM in AS patients. Although the majority of all AS patients eligible for CV-RM received CV risk medication, CV-RM remains a challenge for treating physicians, as treatment targets were not achieved in three-quarter of the eligible patients. BioMed Central 2015-04-09 /pmc/articles/PMC4404047/ /pubmed/25886634 http://dx.doi.org/10.1186/s12891-015-0532-3 Text en © Heslinga et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Heslinga, Sjoerd C
Van den Oever, Inge A
Van Sijl, Alper M
Peters, Mike J
Van der Horst-Bruinsma, Irene E
Smulders, Yvo M
Nurmohamed, Michael T
Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation
title Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation
title_full Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation
title_fullStr Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation
title_full_unstemmed Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation
title_short Cardiovascular risk management in patients with active Ankylosing Spondylitis: a detailed evaluation
title_sort cardiovascular risk management in patients with active ankylosing spondylitis: a detailed evaluation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404047/
https://www.ncbi.nlm.nih.gov/pubmed/25886634
http://dx.doi.org/10.1186/s12891-015-0532-3
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