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传统心血管危险因素在类风湿关节炎患者中的作用。

The role of traditional cardiovascular risk factors among patients with rheumatoid arthritis.

作者信息

Brady Sharmayne R E, de Courten Barbora, Reid Christopher M, Cicuttini Flavia M, de Courten Maximilian P J, Liew Danny

机构信息

Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Prahran, Australia.

出版信息

J Rheumatol. 2009 Jan;36(1):34-40. doi: 10.3899/jrheum.080404.

Abstract

OBJECTIVE

People with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) compared with the general population. We investigated the relative contribution of traditional cardiovascular risk factors to this elevated risk.

METHODS

Fifty RA subjects and 150 age and sex matched controls attended a cardiovascular risk assessment clinic betweenMarch and July 2006. Traditional cardiovascular risk factors and the absolute risks of CVD (calculated from application of a Framingham risk equation) were compared between the 2 groups.

RESULTS

Compared with the controls, RA subjects were more likely to smoke (p<0.001), be physically inactive (p=0.006), and have higher mean measurements of body mass index (p=0.040) and waist circumference (p=0.049). No significant differences were found in mean levels of plasma lipid or glucose, or in the prevalences of diabetes and hypertension. Overall, the mean absolute risk of CVD was higher in the RA group, even after excluding smokers (p=0.036).

CONCLUSION

Smoking and physical inactivity are important risk factors in the management of cardiovascular risk among patients with RA. Subjects with RA seem to have higher absolute risks of CVD compared with controls, even independently of smoking. This highlights the importance of treating all modifiable risk factors in those with RA although, individually, few may be conspicuous.

摘要

目的

与普通人群相比,类风湿关节炎(RA)患者患心血管疾病(CVD)的风险更高。我们调查了传统心血管危险因素对这种风险升高的相对贡献。

方法

2006年3月至7月期间,50名RA患者和150名年龄及性别匹配的对照者前往心血管风险评估门诊。比较了两组之间的传统心血管危险因素和CVD的绝对风险(通过应用弗雷明汉风险方程计算)。

结果

与对照组相比,RA患者更有可能吸烟(p<0.001)、身体活动不足(p=0.006),且体重指数(p=0.040)和腰围(p=0.049)的平均测量值更高。血浆脂质或葡萄糖的平均水平、糖尿病和高血压的患病率均未发现显著差异。总体而言,即使排除吸烟者后,RA组CVD的平均绝对风险仍较高(p=0.036)。

结论

吸烟和身体活动不足是RA患者心血管风险管理中的重要危险因素。与对照组相比,RA患者似乎具有更高的CVD绝对风险,即使独立于吸烟因素。这凸显了治疗RA患者所有可改变危险因素的重要性,尽管个别危险因素可能并不明显。

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