Elevated Cardiovascular Disease Risk in Patients With Inflammatory Arthritis

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Researchers assessed the prevalence and incidence rate of cardiovascular morbidity in patients with inflammatory arthritis and determined whether the coexistence of multiple autoimmune disorders was associated with increased risk for cardiovascular disease.

The rate of cardiovascular disease is increased among patients with inflammatory arthritis, particularly among those who have multiple autoimmune disorders, according to study results published in Rheumatology.

The study included data of patients with inflammatory arthritis only and patients with inflammatory arthritis and another comorbid autoimmune disorder; control participants were enrolled in the study from the Nivel Primary Care Database. Researchers used Cox regression models to determine hazard ratios (HRs) for the risk for cardiovascular disease.

Among 28,345 patients with inflammatory arthritis, 13.5% had ≥1 concomitant autoimmune disorders compared with 7.3% of the 28,249 matched controls.

Results of the study indicated that compared with the control participants, patients with inflammatory arthritis had both higher prevalence (odds ratio [OR], 1.34; 95% CI, 1.28-1.41) and incidence rates (incidence rate ratio, 1.3; 95% CI, 1.23-1.41). Compared with patients with inflammatory arthritis alone (HR, 1.32; 95% CI, 1.23-1.41), patients with a second comorbid autoimmune disease had an even higher risk for cardiovascular disease, with an HR of 1.49 (95% CI, 1.31-1.68).

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Compared with the control participants, patients with inflammatory arthritis had higher rates of other conditions, including type 1 diabetes (OR, 1.80; 95% CI, 1.27-2.55), hypothyroidism (OR, 1.49; 95% CI, 1.37-1.61), psoriasis (OR, 2.72; 95% CI, 2.49-2.97), and inflammatory bowel disease (OR, 2.64; 95% CI, 2.28-3.07).

Study limitations included the use of ICPC-code L88, which encompasses a few different diagnoses, and a possibility of misclassification, and the fact that data on smoking status and other cardiovascular risk factors were unavailable.

“Because of the increased risk [for] a second autoimmune disorder in inflammatory arthritis patients, physicians should screen for signs or symptoms of those diseases,” the researchers concluded.


Heslinga M, Nielen MMJ, Smulders Y, Simsek S, Nurmohamed MT. Amplified prevalence and incidence of cardiovascular disease in patients with inflammatory arthritis and coexistent autoimmune disorders [published online January 18, 2020]. Rheumatology. doi:10.1093/rheumatology/kez650