Anyfanti Panagiota, Ainatzoglou Alexandra, Angeloudi Elena, Michailou Olga, Defteraiou Kleopatra, Bekiari Eleni, Kitas George D, Dimitroulas Theodoros
Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Mediterr J Rheumatol. 2024 Sep 30;35(3):402-410. doi: 10.31138/mjr.310824.cri. eCollection 2024 Sep.
In the context of holistic therapeutic practices, the cardiovascular risk of patients with rheumatoid arthritis (RA) needs to be addressed as a major factor of compromised disease prognosis and increased mortality. The elevated prevalence of cardiovascular disease (CVD) by more than twofold in RA has been attributed, inter alia, to chronic inflammation exacerbating arterial stiffness, increased onset of hypertension, dyslipidaemia and diabetes mellitus, sedentary lifestyle, and antirheumatic drug complications. CVD risk in RA can be currently assessed by practitioners through accessible adapted calculators, but it remains problematic as their diagnostic accuracy is not superior to calculators designed for the general population. Implementation of guideline-oriented personalised interventions remains the cornerstone for cardiovascular risk management in RA. Remarkably, there is lack of a consortium that brings together different health care providers engaged in the care of patients with RA (e.g., rheumatologists, cardiologists, general practitioners, etc), to guide cardiovascular risk assessment and management. This narrative review aims at providing an overview of current CVD risk assessment and management options, highlighting their pivotal role in the comprehensive treatment of RA patients.
在整体治疗实践的背景下，类风湿关节炎（RA）患者的心血管风险需要作为疾病预后受损和死亡率增加的主要因素加以关注。RA患者心血管疾病（CVD）的患病率升高了两倍多，这尤其归因于慢性炎症加剧动脉僵硬、高血压、血脂异常和糖尿病的发病增加、久坐不动的生活方式以及抗风湿药物并发症。目前，从业者可通过适用的简易计算器评估RA患者的CVD风险，但由于其诊断准确性并不优于为普通人群设计的计算器，所以仍存在问题。实施以指南为导向的个性化干预措施仍然是RA心血管风险管理的基石。值得注意的是，目前缺乏一个由从事RA患者护理的不同医疗保健提供者（如风湿病学家、心脏病学家、全科医生等）组成的联盟，以指导心血管风险评估和管理。本叙述性综述旨在概述当前CVD风险评估和管理方案，强调它们在RA患者综合治疗中的关键作用。
