Physicians have long known that people with rheumatoid arthritis and other rheumatic conditions such as lupus are more likely to die at younger ages than are those without these conditions. Even with advances in treatment, the gap in life expectancy remains.
No one knew why until 15 years ago. That’s when researchers at Mayo Clinic helped establish that people with rheumatoid arthritis have a greater chance of developing various types of cardiovascular disease.
“We now know that rheumatoid arthritis is associated with an increased risk of heart and vascular disease,” says senior researcher Sherine E. Gabriel, M.D., a rheumatologist and epidemiologist in
the Department of Health Sciences Research at Mayo Clinic’s campus in Rochester, Minnesota. “What is less understood is why people with rheumatoid arthritis develop that increased risk.”
The evidence increasingly points to inflammation as a major contributor to that increased risk of cardiovascular disease.
In rheumatoid arthritis, the immune system attacks the synovium — the lining of the membranes around the joints. The resulting inflammation thickens the synovium, which can, in turn, eventually destroy cartilage and bone in the joint.
Inflammation can also cause the inner linings of arteries to swell. This narrows the arteries, raises blood pressure, and reduces blood flow to the heart and other organs.
Eric L. Matteson, M.D., chair of the Division of Rheumatology at Mayo Clinic in Rochester, notes
that people with rheumatoid arthritis have a 50 percent higher risk of heart attack, twice the risk of heart failure and more peripheral vascular disease than people who don’t have rheumatoid arthritis.
“Clearly, there’s something about rheumatoid arthritis that affects the cardiovascular system, causes patients to suffer with more disease and even can affect their life expectancy,” Dr. Matteson says.
An innovative practice at Mayo Clinic’s Cardio-Rheumatology Clinic now gives physicians and patients the information they need to more accurately assess cardiovascular risk and to intervene much earlier. It paves the way for better management of heart disease and improved quality of life for people with rheumatic diseases.
“We’ve come full circle,” Dr. Gabriel notes. “Careful clinical observation led to research that now informs and changes clinical practice, making things better for patients.”
To read the full story about the connection between rheumatoid arthritis and heart disease, visit Discovery’s Edge, Mayo Clinic’s research magazine: http://www.mayo.edu/research/discoverys-edge/rheumatoid-arthritis-heart-disease-connection
To read other stories on recent advances in biomedical research at Mayo Clinic, visit Discovery’s Edge