Issakulova Аinur, Yessirkepov Marlen, Zimba Olena, Kocyigit Burhan Fatih
Department of General Practitioner N2, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
Department of Chemical Disciplines, Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
Rheumatol Int. 2025 Sep 2;45(9):214. doi: 10.1007/s00296-025-05975-4.
Cardiovascular (CV) morbidity and mortality pose major challenges in patients with axial spondyloarthritis (AxSpA), a chronic inflammatory disorder that includes both radiographic and non-radiographic forms. Patients with AxSpA have heightened CV morbidity and mortality, mainly attributable to systemic inflammation and typical CV risk factors like hypertension, hyperlipidemia, diabetes, and obesity. Subclinical atherosclerosis frequently manifests independently of conventional risk factors and is associated with indicators of disease activity and inflammatory load. Established CV risk assessment tools generally underestimate the actual risk in AxSpA, since inflammation leads to endothelial dysfunction and promotes atherosclerosis, highlighting the necessity for customized screening strategies. Pharmacological options, including tumor necrosis factor inhibitors, have demonstrated efficacy in reducing CV risk by mitigating inflammation and improving vascular stability. The role of nonsteroidal anti-inflammatory drugs is intricate, with specific data indicating possible preventive benefits against CV events associated with favorable inflammation management. Lifestyle modifications, including smoking cessation, dietary enhancements-especially adherence to the Mediterranean diet-and increased physical activity are essential adjuncts for mitigating CV risk in this demographic. Innovative digital health technologies and integrated CV-musculoskeletal rehabilitation programs offer promising opportunities for personalized management. Despite progress, further investigation is essential to develop AxSpA-specific CV risk models, investigate sex-specific disparities, and implement multidisciplinary strategies to enhance CV outcomes. Timely identification and thorough treatments are crucial for strengthening long-term outcomes in AxSpA patients.
心血管（CV）发病率和死亡率给中轴型脊柱关节炎（AxSpA）患者带来了重大挑战，AxSpA是一种慢性炎症性疾病，包括影像学和非影像学两种形式。AxSpA患者的心血管发病率和死亡率较高，主要归因于全身炎症以及高血压、高脂血症、糖尿病和肥胖等典型心血管危险因素。亚临床动脉粥样硬化常常独立于传统危险因素出现，并与疾病活动指标和炎症负荷相关。既定的心血管风险评估工具通常会低估AxSpA患者的实际风险，因为炎症会导致内皮功能障碍并促进动脉粥样硬化，这凸显了定制筛查策略的必要性。包括肿瘤坏死因子抑制剂在内的药物治疗方案已证明可通过减轻炎症和改善血管稳定性来降低心血管风险。非甾体抗炎药的作用较为复杂，具体数据表明，对炎症管理良好的患者，这类药物可能对预防心血管事件有益。生活方式的改变，包括戒烟、改善饮食（特别是坚持地中海饮食）和增加体育活动，是降低该人群心血管风险的重要辅助措施。创新的数字健康技术和综合心血管 - 肌肉骨骼康复计划为个性化管理提供了有前景的机会。尽管取得了进展，但仍需进一步研究以开发针对AxSpA的心血管风险模型，调查性别差异，并实施多学科策略以改善心血管结局。及时识别和全面治疗对于改善AxSpA患者的长期预后至关重要。
