1st Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Curr Vasc Pharmacol. 2020;18(5):473-487. doi: 10.2174/1570161117666190426164306.
The spondyloarthritides are a group of chronic systemic inflammatory joint diseases, the main types being ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Evidence accumulating during the last decades suggests that patients with AS or PsA carry an increased risk for cardiovascular disease and cardiovascular death. This risk appears to be mediated by systemic inflammation over and above classical cardiovascular risk factors. The excess cardiovascular risk in those patients has been formally acknowledged by scientific organizations, which have called physicians' attention to the matter. The application by Rheumatologists of new effective anti-rheumatic treatments and treat-to-target strategies seems to benefit patients from a cardiovascular point of view, as well. However, more data are needed in order to verify whether anti-rheumatic treatments do have an effect on cardiovascular risk and whether there are differences among them in this regard. Most importantly, a higher level of awareness of the cardiovascular risk is needed among patients and healthcare providers, better tools to recognize at-risk patients and, ultimately, commitment to address in parallel both the musculoskeletal and the cardiovascular aspect of the disease.
脊柱关节炎是一组慢性全身性炎症性关节疾病，主要类型为强直性脊柱炎（AS）和银屑病关节炎（PsA）。过去几十年积累的证据表明，患有 AS 或 PsA 的患者发生心血管疾病和心血管死亡的风险增加。这种风险似乎是由全身性炎症引起的，而不仅仅是传统的心血管危险因素。科学组织已经正式承认这些患者的心血管风险过高，并提请医生注意这一问题。风湿病医生应用新的有效抗风湿治疗和达标治疗策略，似乎也能从心血管角度使患者受益。然而，还需要更多的数据来验证抗风湿治疗是否对心血管风险有影响，以及它们在这方面是否存在差异。最重要的是，患者和医疗保健提供者需要提高对心血管风险的认识，需要更好的工具来识别高危患者，最终致力于同时解决疾病的肌肉骨骼和心血管方面的问题。
