A study published in Arthritis Care & Research has suggested that although rheumatoid arthritis is linked with an increased risk for cardiovascular disease, it does not increase the risk as significantly as does diabetes.
Researchers drew on both public and private health plan claims, made between 2006 and 2010, of 920,772 participants to assess whether rheumatoid arthritis should be considered equivalent in risk to diabetes when considering management of hyperlipidemia. Patients were at least 40 years old and did not have prevalent cardiovascular disease. The researchers grouped them into separate cohorts according to whether they had diabetes, rheumatoid arthritis, both, or neither.
The rate of hospitalization due to stroke, myocardial infarction, and coronary revascularization was determined from inpatient discharge diagnosis codes and procedure codes. Incidence rates (IR) were compiled of the outcomes for all 4 cohorts using the 2010 US census distribution for sex and age. These IRs were measured in units per 1000 person-years.
The incidence rate for myocardial infarction was highest in patients with both rheumatoid arthritis and diabetes (IR=12.6; 95% CI, 10.7-14.7). The second highest rate was seen in patients with diabetes (IR=10.7; 95%CI, 10.3-11.0), the third was seen in those with rheumatoid arthritis (IR=5.7; 95% CI, 5.2-6.3), and the lowest was seen in those with neither diagnosis (IR=4.2; 95% CI, 4.1-4.3).
These findings suggest that “while CVD risk in RA is elevated, it is lower in magnitude compared to the CVD risk associated with diabetes. It therefore may not be appropriate to consider RA a diabetes risk-equivalent with respect to hyperlipidemia management.”
Curtis JR, Yang S, Singh JA, et al. Is rheumatoid arthritis a cardiovascular risk equivalent to diabetes? [published online February 6, 2018]. Arthritis Care Res (Hoboken). doi: 10.1002/acr.23535