Wibetoe Grunde, Ikdahl Eirik, Rollefstad Silvia, Olsen Inge C, Bergsmark Kjetil, Kvien Tore K, Salberg Anne, Soldal Dag Magnar, Bakland Gunnstein, Lexberg Åse, Fevang Bjørg-Tilde, Gulseth Hans Christian, Haugeberg Glenn, Semb Anne Grete
Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vinderen, N-0319, Oslo, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Arthritis Res Ther. 2017 Jul 3;19(1):153. doi: 10.1186/s13075-017-1358-1.
Patients with inflammatory joint diseases (IJD) have increased risk of cardiovascular disease (CVD). Our aim was to compare CVD risk profiles in patients with IJD, including rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) and evaluate the future risk of CVD.
The prevalence and numbers of major CVD risk factors (CVD-RFs) (hypertension, elevated cholesterol, obesity, smoking, and diabetes mellitus) were estimated in patients with RA, axSpA and PsA. Relative and absolute risk of CVD according to Systematic Coronary Risk Evaluation (SCORE) was calculated.
In total, 3791 patients were included. CVD was present in 274 patients (7.2%). Of those without established CVD; hypertension and elevated cholesterol were the most frequent CVD-RFs, occurring in 49.8% and 32.8% of patients. Patients with PsA were more often hypertensive and obese. Overall, 73.6% of patients had a minimum of one CVD-RF, which increased from 53.2% among patients aged 30 to <45 years, to 86.2% of patients aged 60 to ≤80 years. Most patients (93.5%) had low/moderate estimated risk of CVD according to SCORE. According to relative risk estimations, 35.2% and 24.7% of patients had two or three times risk or higher, respectively, compared to individuals with no CVD-RFs.
In this nationwide Norwegian project, we have shown for the first time that prevalence and numbers of CVD-RFs were relatively comparable across the three major IJD entities. Furthermore, estimated absolute CVD risk was low, but the relative risk of CVD was markedly high in patients with IJD. Our findings indicate the need for CVD risk assessment in all patients with IJD.
炎症性关节疾病（IJD）患者患心血管疾病（CVD）的风险增加。我们的目的是比较IJD患者（包括类风湿关节炎（RA）、轴性脊柱关节炎（axSpA）和银屑病关节炎（PsA））的CVD风险特征，并评估CVD的未来风险。
对RA、axSpA和PsA患者的主要CVD危险因素（CVD-RFs）（高血压、胆固醇升高、肥胖、吸烟和糖尿病）的患病率和数量进行了估计。根据系统冠状动脉风险评估（SCORE）计算CVD的相对和绝对风险。
共纳入3791例患者。274例患者（7.2%）存在CVD。在未确诊CVD的患者中，高血压和胆固醇升高是最常见的CVD-RFs，分别发生在49.8%和32.8%的患者中。PsA患者高血压和肥胖的情况更为常见。总体而言，73.6%的患者至少有一项CVD-RF，这一比例从30至<45岁患者中的53.2%增加到60至≤80岁患者中的86.2%。根据SCORE，大多数患者（93.5%）的CVD估计风险较低/中等。根据相对风险估计，与无CVD-RF的个体相比，分别有35.2%和24.7%的患者有两倍或三倍及以上的风险。
在这个挪威全国性项目中，我们首次表明，在三个主要的IJD实体中，CVD-RFs的患病率和数量相对可比。此外，CVD的估计绝对风险较低，但IJD患者的CVD相对风险明显较高。我们的研究结果表明，所有IJD患者都需要进行CVD风险评估。
