In patients with inflammatory joint diseases, the inclusion of cardiovascular disease (CVD) risk assessments in addition to clinical joint examination can be feasible in daily rheumatology practice, according to results from the Norwegian Collaboration on Atherosclerosis in Patients with Rheumatic Joint Diseases (NOCAR) project published in RMD Open.

The European League Against Rheumatism has recommended the implementation of CVD risk assessments for patients with inflammatory joint diseases. Despite this recommendation, the actual implementation of assessments has been underwhelming.

The NOCAR project began in April 2014 as a quality assurance project that included 11 Norwegian rheumatology clinics. To assess CVD risk in participants, rheumatologists added lipid measurements to routine laboratory tests, took blood pressure measurements, and had participants self-report CVD risk factors in addition to performing clinical joint examinations.


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The rheumatologists calculated participants’ CVD risks using the European systematic coronary risk evaluation algorithm. If a patient had high or very high CVD risk, he or she was referred to the primary care clinician for initiation of CVD preventive measures.

By autumn 2015, 5 of the 11 centers had implemented CVD risk assessments. A total of 8789 participants were eligible for CVD risk evaluation and 41.4% of those underwent assessment.

These results of this study indicate that CVD risk assessment can feasibly be implemented in routine rheumatology practice.

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“Through a Norwegian nationwide project, we have shown that CVD risk assessments can be feasible as a part of a daily rheumatology practice, but that this requires changes in process that [are] likely to require some time before they are functioning optimally,” the researchers wrote.

The researchers hope that other countries will implement similar strategies to improve CVD prevention in patients with inflammatory joint diseases.

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Reference

Ikdahl E, Rollefstad S, Wibetoe G, et al. Feasibility of cardiovascular disease risk assessments in rheumatology outpatient clinics: experiences from the nationwide NOCAR project. RMD Open. 2018;4:e000737.