Open AccessHigh ten‐year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients: A population‐based cohort study
Author(s) -
Kremers Hilal Maradit,
Crowson Cynthia S.,
Therneau Terry M.,
Roger Veronique L.,
Gabriel Sherine E.
Publication year - 2008
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.23650
Subject(s) - medicine , absolute risk reduction , rheumatoid arthritis , cohort , dyslipidemia , population , body mass index , incidence (geometry) , risk factor , cohort study , obesity , confidence interval , environmental health , physics , optics
Objective To estimate the 10‐year absolute risk of cardiovascular (CV) events in newly diagnosed rheumatoid arthritis (RA) patients and the potential contribution of CV risk factors to absolute risk assessment. Methods A population‐based incidence cohort of RA patients (defined according to the American College of Rheumatology 1987 criteria) was assembled and compared with an age‐ and sex‐matched non‐RA cohort. Data were collected on CV risk factors and CV events. Cox regression models were used to estimate the 10‐year risk of a combined CV end point, adjusting for CV risk factors. Subjects were classified into 5 risk categories based on their 10‐year absolute risk. Results The absolute CV risk in RA patients was similar to that in non‐RA subjects who were 5–10 years older. The absolute risk varied substantially according to the presence of CV risk factors. The 10‐year absolute CV risk among 60–69‐year‐old RA patients with no risk factors was 16.8%, but rose to 60.4% if risk factors such as smoking, hypertension, dyslipidemia, diabetes, and obesity were present. Among RA patients with a low body mass index, in addition to the above risk factors, the 10‐year absolute CV risk rose to 86.2%. Conclusion More than half of the newly diagnosed RA patients who were 50–59 years of age and all of those >60 years of age had a >10% risk of CV disease within 10 years of their RA incidence and should be targeted for specific CV risk reduction strategies tailored to their personal risk profiles.