Institute for Regional Health Research, University of Southern Denmark, Hospital of Southern Jutland, Aabenraa and King Christian X's Hospital for Rheumatic Diseases, , Graasten, Denmark.
Ann Rheum Dis. 2013 Nov;72(11):1771-6. doi: 10.1136/annrheumdis-2013-203682. Epub 2013 Jul 12.
To investigate risk factors for the development of cardiovascular disease (CVD) and estimate the risk of cardiovascular death in rheumatoid arthritis (RA) patients in accordance with EULAR recommendations.
Outpatients with RA ≤85 years of age from a Danish hospital were invited to participate. Patients' risk of cardiovascular death was calculated according to the SCORE system, based on total cholesterol/high-density lipoprotein (HDL) ratio, smoking habits, blood pressure, age and gender. The SCORE was adjusted based on disease duration, IgM-RF/anti-CCP positivity and the presence of extra-articular manifestations. Factors such as history of CVD, hypertension or diabetes mellitus (DM), fasting glucose, exercise habits, body mass index (BMI) and waist circumference were explored.
836 patients participated; 71.5% women; mean (SD) age 64.3 years (12.0); 152 (19.1%) were already diagnosed with CVD and 74 (9.0%) with DM. Among the 644 patients without CVD or DM, 158 (24.5%) were smokers, 229 (35.8%) had a systolic blood pressure ≥140, 397 (65.6%) total cholesterol ≥5.0 mM/L, 326 (55.4%) low-density lipoprotein cholesterol ≥3.0 mM/L, 18 (4.0%) women and 19 (12.1%) men had a HDL-cholesterol level below 1.2/1.0 mM/L. BMI was >25 in 409 (63.8%). Waist circumference was above 80/94 cm in 297 (63.3%) of female and 111 (63.8%) of male patients, respectively, and 418 (64.9%) exercised ≤5 times a week. Among patients without DM, 14.3% had a fasting glucose ≥6.0 mmol/L. The SCORE was ≥5 in 122 (20.2%). They were referred to follow-up by their GP and community advice services.
Systematic screening revealed several risk factors that needed medical follow-up or support to initiate lifestyle changes.
根据 EULAR 建议，调查心血管疾病 (CVD) 发展的风险因素，并估计类风湿关节炎 (RA) 患者发生心血管死亡的风险。
邀请丹麦一家医院 ≤85 岁的 RA 门诊患者参加。根据总胆固醇/高密度脂蛋白 (HDL) 比值、吸烟习惯、血压、年龄和性别，利用 SCORE 系统计算患者心血管死亡风险。根据疾病持续时间、IgM-RF/抗 CCP 阳性和关节外表现的存在，调整 SCORE。还探讨了 CVD 史、高血压或糖尿病 (DM)、空腹血糖、运动习惯、体重指数 (BMI) 和腰围等因素。
836 例患者参与；71.5%为女性；平均（SD）年龄 64.3 岁（12.0）；152 例（19.1%）已诊断为 CVD，74 例（9.0%）患有 DM。在 644 例无 CVD 或 DM 的患者中，158 例（24.5%）为吸烟者，229 例（35.8%）收缩压≥140mmHg，397 例（65.6%）总胆固醇≥5.0mmol/L，326 例（55.4%）低密度脂蛋白胆固醇≥3.0mmol/L，18 例（4.0%）女性和 19 例（12.1%）男性 HDL-胆固醇水平<1.2/1.0mmol/L。409 例（63.8%）BMI>25。297 例（63.3%）女性和 111 例（63.8%）男性患者的腰围均高于 80/94cm，418 例（64.9%）每周运动次数≤5 次。在无 DM 的患者中，14.3%的空腹血糖≥6.0mmol/L。SCORE≥5 的有 122 例（20.2%）。他们由全科医生和社区咨询服务机构转介进行随访。
系统筛查发现了一些需要医学随访或支持以启动生活方式改变的风险因素。
