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Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis: A dose-response relationship independent of established cardiovascular risk factors
Rheumatology, 10/28/09

Crilly MA et al. – To quantify the relationship between arterial stiffness and cumulative inflammatory burden in patients with RA. In RA patients free of overt arterial disease, a dose–response relationship exists between cumulative inflammatory burden and arterial stiffness. This relationship is independent of established CV risk factors.

Methods

Recruited RA patients without overt arterial disease aged 40–65 years, attending hospital rheumatology outpatient clinics
Standardized research nurse assessment included blood pressure (BP), pulse wave analysis (PWA, SphygmoCor), BMI, fasting blood sample (lipids, glucose, RF and ESR), patient questionnaire (smoking, alcohol, diet, exercise, family history of premature coronary heart disease and Stanford HAQ), current medication and medical record review
Cumulative inflammatory burden measured as ESR area-under-the-curve (ESR-years) extracted from medical records
Arterial stiffness measured using PWA
Multiple linear regression was used to adjust for age, sex and nine other cardiovascular risk factors

Results

Recruited 114 RA patients (mean age 54 years, female 81%, current DMARD 90%, current NSAID 70%, ACR criteria 56%) comprising 1040 RA person-years
Cholesterol, glucose and BMI were similar in women and men
Women had longer duration of arthritis (10 vs 7 years) and were more likely to be seropositive (85 vs 71%)
BP, smoking and alcohol consumption lower for women
Fully adjusted analysis restricted to women the increase was 0.43

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