Mackey Rachel H, Kuller Lewis H, Moreland Larry W
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, University of Pittsburgh, 542 Bellefield Professional Building, 130 North Bellefield Avenue, Pittsburgh, PA 15213, USA.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Room 550, Bellefield Professional Building, 130 North Bellefield Avenue, Pittsburgh, PA 15213, USA.
Rheum Dis Clin North Am. 2018 Aug;44(3):475-487. doi: 10.1016/j.rdc.2018.03.006. Epub 2018 Jun 12.
Cardiovascular disease (CVD) risk is 1.5-fold higher in rheumatoid arthritis (RA), partly due to subclinical atherosclerosis that develops before the diagnosis of RA. Dyslipidemia in RA is better quantified by lipoproteins and apolipoproteins than by cholesterol levels. Current risk factors likely underestimate CVD risk by underestimating prior risk factor levels. Some of the 2-fold higher risk of heart failure and total mortality in RA may be due to myocardial disease caused by inflammation. Per recent recommendations, to reduce CVD risk in RA, control disease activity, reduce inflammation, and aggressively treat CVD risk factors.
类风湿关节炎（RA）患者患心血管疾病（CVD）的风险高出1.5倍，部分原因是在RA诊断之前就已出现亚临床动脉粥样硬化。与胆固醇水平相比，通过脂蛋白和载脂蛋白能更好地量化RA中的血脂异常。目前的风险因素可能因低估既往风险因素水平而低估了CVD风险。RA中心力衰竭和总死亡率高出2倍的部分原因可能是炎症引起的心肌疾病。根据最近的建议，为降低RA患者的CVD风险，应控制疾病活动、减轻炎症并积极治疗CVD风险因素。
