Assessment of Cardiovascular Disease Risk and Therapeutic Patterns among Urban Black Rheumatoid Arthritis Patients

Abstract

Rheumatoid arthritis (RA) patients have nearly twice the risk of cardiovascular disease (CVD) compared to the general population. We aimed to assess, in a predominantly Black population, the prevalence of traditional and RA-specific CVD risk factors and therapeutic patterns. Utilizing ICD codes, we identified 503 RA patients ≥18 years old who were seen from 2010 to 2017. Of them, 88.5% were Black, 87.9% were women and 29.4% were smokers. CVD risk factors (obesity, diabetes, hypertension, dyslipidemia) were higher than in previously reported White RA cohorts. Eighty-seven percent of the patients had at least one traditional CVD risk factor, 37% had three or more traditional CVD risk factors and 58% had RA-specific risk factors (seropositive RA, >10 years of disease, joint erosions, elevated inflammatory markers, extra-articular disease, body mass index (BMI) < 20). CV outcomes (coronary artery disease/myocardial infarction, heart failure, atrial fibrillation and stroke) were comparable to published reports. Higher steroid use, which increases CVD risk, and lesser utilization of biologics (decrease CV risk) were also observed. Our Black RA cohort had higher rates of traditional CVD risk factors, in addition to chronic inflammation from aggressive RA, which places our patients at a higher risk for CVD outcomes, calling for revised risk stratification strategies and effective interventions to address comorbidities in this vulnerable population.

Validating potent anti-inflammatory and anti-rheumatoid properties of Drynaria quercifolia rhizome methanolic extract through in vitro, in vivo, in silico and GC-MS-based profiling

“…The disease RA is characterized by synovial hyperplasia, inflammatory cell infiltration in the synovial tissues and progression of this disease leads to the destruction of cartilages and bones and chronic disability of the patient [ 5 ]. Bone joint destruction is associated with chronic inflammation combined with the destruction of the surface and extracellular matrix of articular cartilage, and erosion of bone and if undiagnosed, it hampers the quality of lifestyle [ 6 , 7 ]. The inflammation during RA results in the redness and swelling of the joint regions which is associated with the elevation of the temperature in the inflamed region and evokes severe pain [ 8 ].…”

A review of fibroblast-like synoviocytes in the pathogenesis of Rheumatoid arthritis: Their activation and the inhibition of their apoptosis

“…The deterioration results in chronic pathology 2, 3 . Infiltrated immune cells cause degradation of the surface and extracellular matrix of the articular cartilage, cause bone erosion, and reduce the quality of life 4, 5 . The exact cause of RA is elusive.…”