Five hundred men and 500 women, aged 40 or over, with rheumatoid arthrntis, together with a control population matched for age and sex, were observed over 10 years. During that time 352 patients with rheumatoid arthritis (208 men, 144 women) and 221 controls (148 men, 73 women) died. The overall mortality was significantly higher (p<0-0001) in both men and women with rheumatoid arthritis than in the controls.Infections and cardiovascular and renal diseases (especially amyloidosis) appeared to be the main causes of death in rheumatoid arthritis.

Patients with rheumatoid arthritis (RA), 500 men and 500 women, aged 40 years and over, together with a control population matched by age and sex were followed up with respect to cause-specific mortality over a 10-year period. The overall mortality was significantly higher in both men and women with RA than in the controls. A statistically significant increase in mortality from all cardiovascular diseases (p < 0.001) and cardiac diseases (p = 0.004) was observed in men with RA but not in women with RA compared to corresponding controls. No difference in mortality from cerebrovascular diseases was observed between RA patients and controls.

SUMMARY Patients with rheumatoid arthritis (RA), 500 men and 500 women, aged 40 years and over, together with a control population matched by age and sex, were observed over a 10 year period. The overall mortality was significantly higher in both men and women with rheumatoid arthritis than in the controls due to an excess mortality from infections and cardiovascular and renal diseases. During the follow up 31 patients with RA (12 male, 19 female) and one male control subject died from amyloidosis and 42 RA patients (19 male, 23 female) and one male control from renal diseases. The most important causes of renal deaths were chronic nephritis and renal infections.

Epidemiological studies have suggested that patients with rheumatoid arthritis (RA) have increased mortality due to cardiovascular disease. We studied cardiac performance in 12 asymptomatic male patients with RA and 14 control subjects to elucidate early disturbances in cardiac function. In echocardiography, isovolumic relaxation time was longer (64 +/- 6 vs. 49 +/- 3 ms, mean +/- SEM, P = 0.010) and peak filling rate (134 +/- 10 vs. 159 +/- 6 mm s-1, P = 0.015) lower in patients with RA than in control subjects, reflecting an impairment in left ventricular diastolic function. Left ventricular systolic function assessed by radionuclide angiocardiography at rest and during exercise was similar in both groups. There were no differences between the patients with RA and control subjects in the heart rate, systolic blood pressure and oxygen uptake during peak exercise. Left ventricular diastolic function is impaired in spite of normal left ventricular systolic function in patients with RA without clinically evident cardiovascular disease and this may contribute to the excess of cardiovascular mortality in patients with RA.

Patients with rheumatoid arthritis, 500 males and 500 females, aged 40 years or over, and an age- and sex-matched control population were observed over a 3-year period. During the follow-up, 122 RA patients and 69 controls had died. The most common causes of death in RA patients were cardiovascular diseases (57 patients), renal failure (27 patients), infections (19 patients), and malignant neoplasms (11 patients); in the controls, the respective data are: cardiovascular diseases (35 people), malignant neoplasms (21 people), accidents (7 people), and infections (5 people).