CVD Prevention Measures Inadequate in Patients With Inflammatory Joint Diseases
Inadequate cardiovascular disease prevention measures were observed in rheumatoid arthritis, axial spondyloarthritis, and psoriatic arthritis.
There is an unmet need for cardiovascular disease (CVD) prevention measures for patients with inflammatory joint diseases, despite the increased risk for CVD in this patient population, according to results published in the International Journal of Cardiology.
The study included participants from the Norwegian Collaboration on Atherosclerosis in Patients With Rheumatic Joint Diseases Project. Indications for antihypertensive treatment included systolic/diastolic blood pressure ≥140/90 mm Hg and self-reported hypertension or antihypertensive treatment. The researchers estimated CVD risk using the systematic coronary risk evaluation (SCORE) algorithm. Low-density lipoprotein (LDL) cholesterol goals were <2.6 mmol/L for participants with diabetes, total cholesterol >8 mmol/L or a SCORE estimate ≥5%, and <1.8 mmol/L for those with established CVD or SCORE ≥10%.
Overall, the study included 2277 participants, including 1376 with rheumatoid arthritis, 474 with axial spondyloarthritis, and 427 with psoriatic arthritis.
Lipid-lowering therapy was indicated for 36.1% of participants, 37.6% of whom were untreated, and antihypertensive treatment was indicated for 52.6% of participants, 47.0% of whom were untreated.
Participants achieved LDL cholesterol targets in 26.2% of cases, and blood pressure targets in 26.3% of cases.
The researchers found that even among participants who initiated lipid-lowering therapy or antihypertensive treatment, guideline-recommended treatment or corresponding treatment targets were not initiated or obtained in approximately 50% of cases. They found that participants with rheumatoid arthritis had an increased risk for undertreatment with lipid-lowering therapy, and participants with psoriatic arthritis had an increased risk for hypertension undertreatment.
"The results confirm our hypothesis that suboptimal CVD prevention is not an issue specifically related to [rheumatoid arthritis], but rather a problem that is prevalent in all the 3 major [inflammatory joint disease] entities," the researchers wrote.
Ikdahl E, Wibetoe G, Rollefstad S, et al. Guideline recommended treatment to targets of cardiovascular risk is inadequate in patients with inflammatory joint disease [published online July 2, 2018]. Int J Cardiol. doi: 10.1016/j.ijcard.2018.06.111