Cardiovascular Risk Factors in Chronic Inflammatory Rheumatic Diseases: Modern Assessment and Diagnosis

Abstract

The current view is that systemic inflammation, which is specific to all chronic inflammatory rheumatic diseases (CIRD), accelerates atherogenesis; this hypothesis is supported by the high cardiovascular (CV) morbidity and mortality rates and the high prevalence of all atherosclerosis stages and complications in CIRD patients. The assessment of traditional CV risk factors underestimates the actual risk in patients with CIRD. A comprehensive evaluation and follow-up of both traditional and non-traditional CV risk factors, as well as the correct classification of risk reduction categories are necessary. Imaging techniques (e.g. carotid intima-media thickness and flow-mediated vasodilation) can be used for the early diagnosis of endothelial dysfunction. Immunologic and metabolic markers (anti-cyclic citrullinated peptide (CCP) antibodies, IgM rheumatoid factor, circulating immune complexes, proinflammatory cytokines, TH0/TH1 lymphocytes and homocysteine) may be involved in the atherosclerotic disease development specific to CIRD. A modern therapeutic approach should include the early diagnosis of endothelial dysfunction and atherosclerosis, treatment of CIRD, specific medication designed to control atherosclerosis, changes in patient lifestyle and periodic follow-ups. The assessment and diagnosis of traditional and non-traditional CV risk factors, followed by aggressive prevention and therapy, are necessary to achieve efficient control over the inflammation, immunologic and metabolic disorders specific to CIRD.

Plasma Homocysteine Concentrations In Patients With Rheumatoid Arthritis

“…Timely identification of patients with risk factors, particularly with new risk factors, enables adequate prevention of and treatment for CVD in rheumatoid arthritis patients. antibodies, IgM rheumatoid factor, proinflammatory cytokines and homocysteine) may play a role in the development of atherosclerotic disease in people with RA (17). This hypothesis is supported by the high cardiovascular (CV) morbidity and mortality rates and the high prevalence of all atherosclerosis stages and complications among RA patients (1).…”

“…The current view is that systemic inflammation, which is specific to all chronic inflammatory rheumatic diseases (CIRD), accelerates atherogenesis (17 Values are represented as the mean ± SD, ESR-erythrocytes sedimentation rates, CRP-C-reactive protein, Hcy-homocysteine Table 3. Correlation between the plasma concentrations of homocysteine and the studied factor in RA patients and healthy controls RA-rheumatoid arthritis, BMI-body mass index, ESR-erythrocytes sedimentation rates, CRP-C-reactive protein, HAQ-Health assessment questionnaire-disability index score scores from the HAQ, and the number of swollen and painful joints) and hyperhomocysteinaemia.…”

Medicinal Plants of the Family Lamiaceae in Pain Therapy: A Review

“…By acting also on cardiovascular system and being used as an adjuvant for diabetes control, Origanum subsp. could both prevent and treat more complex diseases associative developed as: atrial fibrillation development [ 262 – 265 ].…”

The Link Between Inflammaging and Degenerative Joint Diseases

“…It is well known that the aging process is associated with the appearance of various pathologies such as frailty, atherosclerosis, Alzheimer’s disease, sarcopenia, type 2 diabetes, or osteoporosis [1,2]. All these conditions have a common pathogenic mechanism characterized by the presence of a low-grade proinflammatory status (Figure 1).…”