BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease and affects various parts of the body, especially the joints, through inflammation. Sestrins are molecules that are known to have anti-inflammatory properties and have been shown to play a role in the stress response in the body. METHODS: Our study is an observational study. Fifty-five RA patients followed in the Rheumatology outpatient clinic and 55 control groups with similar demographic characteristics to this patient group were included in the study. The disease activity scores, cardiac parameters and Sestrin-1 levels of the participants were measured and both groups were compared. RESULTS: There were no differences observed between the two groups in demographic characteristics. Right Carotid intima media thickness (CIMT) levels were found to be significantly higher in RA patients (p = 0.036). Sestrin-1 levels were determined to be significantly lower in RA patients compared to the control group (p<0.001). According to multivariate analysis results, a 1 unit decrease in Sestrin-1 measurement reduces the risk of RA by 0.633 times (p = 0.031). CONCLUSION: Our study is the first to show that decreasing of Sestrin-1 may play a potential role of subclinical atherosclerosis in RA patients. However, the nature of this relationship and the potential role of Sestrin-1 in the treatment of RA still requires further investigation.