Gender Differences in Cardiovascular Risk Profile in Rheumatoid Arthritis Patients with Low Disease Activity

Abstract

Objective. Patients with rheumatoid arthritis (RA) have an excess risk of cardiovascular (CV) disease (CVD). The objective of the study was to compare CV risk profile in female and male RA patients with low disease activity. Materials and Methods. The study group consisted of 70 RA patients with continuous low disease activity and no CVD (54 women, 16 men) and 33 healthy controls of comparable age. The groups were assessed for blood pressure, serum amino-terminal pro-brain natriuretic peptide (NT-proBNP), carotid intima media thickness (cIMT), electrocardiography, ejection fraction (EF), and diastolic dysfunction (DD). Results. Significantly higher burden of atherosclerosis, as revealed by higher cIMT, was found in males [0.93 (0.2) mm] vs females [0.80 (0.2) mm]. The risk of 10-year CVD was significantly higher in men than in women with RA. High/very high risk of fatal CVD was found in 62.5% of male patients. Males were significantly more often current/ex-smokers and had lower HDL-cholesterol and higher atherogenic index. There were no significant differences in NT-proBNP, QTc duration, and parameters of EF and DD. Conclusions. In RA patients with continued low disease activity, a higher burden of atherosclerosis was found in males than in females. The data suggest a significant impact of traditional CV risk factors.

Incident arterial vascular events in a cohort of Puerto Ricans with rheumatoid arthritis

“… 25 Interestingly, in a group of RA patients with low disease activity and no history of cardiovascular disease, men had a significantly higher risk of cardiovascular-related mortality and atherosclerosis when compared to females. 26 The differences observed between our study and others could be related to diversity in genetic and socioeconomic factors, access to health care, comorbidities, and length of follow-up, among others.…”

Analysis of risk factors for the development of cardiovascular diseases in patients with rheumatoid arthritis, depending on gender

“…In one of the most recent works recently published, there was found significantly worst lesion of atherosclerosis in male RA patients compared with female RA patients. This study showed high and very high risk of fatal CVD in most male RA patients [17].…”

Plasma expression of microRNA-425-5p and microRNA-451a as biomarkers of cardiovascular disease in rheumatoid arthritis patients

“…The prevalence of traditional cardiovascular risk factors is different between men and women 42 . Furthermore, disease activity may affect the burden of atherosclerosis 43 and it has been described that measures of disease activity seem to be worse in women than in men 44 . In addition, sex hormones may also be the basis for the differences, as it has been shown that estrogens decrease the inflammatory immune response 45 and hormone replacement therapy shows a beneficial effect on RA disease activity 46 .…”