Rheumatoid arthritis patients at higher risk for unrecognized heart disease and cardiac sudden death

ROCHESTER, Minn. -- People with rheumatoid arthritis not only have a higher risk of coronary heart disease than those in the general population, but they have more silent, unrecognized heart attacks and sudden cardiac deaths, according to a Mayo Clinic study published in the February issue of Arthritis & Rheumatism (http://www.rheumatology.org/publications/ar). They are also much less likely to complain of chest pain.

The increased heart disease risk may be present even before the diagnosis of rheumatoid arthritis, according to the researchers. During the two years before diagnosis of rheumatoid arthritis, patients with this disease were three times more likely to have been hospitalized for an acute heart attack and five times more likely to have an unrecognized heart attack. They were also less likely to have had a history of chest pain, compared to those without rheumatoid arthritis. After their diagnosis, the rheumatoid arthritis patients were twice as likely to experience unrecognized heart attacks and sudden cardiac deaths.

Hilal Maradit Kremers, M.D., lead study investigator and research associate in the Mayo Clinic Department of Health Sciences Research, says the study suggests three major messages for rheumatoid arthritis patients:

  • The risk of heart attack is already there at the time a rheumatoid arthritis diagnosis is first made.

  • Heart disease can remain silent in those with rheumatoid arthritis. Regular cardiac checkups are important, as is lowering traditional cardiac risk factors, such as taking care of blood pressure and cholesterol and quitting smoking.

  • Heart disease in rheumatoid arthritis patients can manifest for the first time as a cardiac sudden death.

The researchers were surprised to find that the increased cardiac events in rheumatoid arthritis patients could not be explained by an increase in tradition

Contact: Lisa Lucier
Mayo Clinic

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