Risk of Cardiovascular Disease in Patients With Osteoarthritis: A Prospective Longitudinal Study

Abstract

Objective. To determine the risk of cardiovascular disease (CVD) among osteoarthritis (OA) patients using populationbased administrative data from British Columbia, Canada. Methods. The medical history of a random sample of 600,000 individuals from 1991-2009 was analyzed. A total of 12,745 OA cases and up to 3 non-OA individuals matched by age, sex, and year of diagnosis were followed for CVD events. Cox proportional hazards and Poisson regression models were used to estimate the relative risks (RRs) of CVD, myocardial infarction, ischemic heart disease (IHD), congestive heart failure (CHF), and stroke after adjusting for available sociodemographic and medical factors. Results. OA was an independent predictor of CVD. The adjusted RRs were 1.15 (95% confidence interval [95% CI] 1.04 -1.27), 1.26 (95% CI 1.13-1.42), and 1.17 (95% CI 1.07-1.26) among older men, younger women, and older women, respectively. Analyses were stratified by age and sex due to statistically significant interactions between OA and age and sex. RRs among older men, younger women, and older women were 1.33 (95% CI 1.11-1.62), 1.66 (95% CI 1.37-2.01), and 1.45 (95% CI 1.22-1.72) for IHD, respectively, and 1.25 (95% CI 1.02-1.54), 1.29 (95% CI 1.00 -1.68), and 1.20 (95% CI 1.03-1.39) for CHF, respectively. Compared to non-OA individuals, OA cases who underwent total joint replacements had a 26% increased risk of CVD. Conclusion. This prospective longitudinal study suggests that OA is associated with an increased risk of CVD. Older men and adult women with OA had a higher risk of CVD, particularly IHD and CHF. Further studies are needed to confirm these results and to elucidate the potential biologic mechanisms.

Sex Variations in the Effects of Arthritis and Activity Limitation on First Heart Disease Event Occurrence in the Canadian General Population: Results From the Longitudinal National Population Health Survey

“…Results from the present study are partially consistent with findings by Nuesch et al and Rahman et al , who reported increased risks of CVD associated with OA. Nuesch et al , however, reported similar excess risks for CVD mortality in men and women with OA.…”

Role of Nonsteroidal Antiinflammatory Drugs in the Association Between Osteoarthritis and Cardiovascular Diseases: A Longitudinal Study

“…The higher risk of CVD in OA patients observed in our study was consistent with previous research findings . For example, in a systematic review and meta‐analysis of observational studies, OA patients were found to be at 24% greater risk of CVD compared to controls without OA .…”

“…For example, in a systematic review and meta‐analysis of observational studies, OA patients were found to be at 24% greater risk of CVD compared to controls without OA . The risk of stroke in the present study was consistent with the risk among female OA patients younger than 65 years reported by Rahman et al . Overall, in this study OA patients showed a relatively higher risk of stroke compared to the risk reported in previous studies.…”

Cause-specific mortality in osteoarthritis of peripheral joints

“…In the present study, we found that knee and hip OA leads to higher mortality from chronic ischemic heart diseases and heart failure with HRs close to 1.2. Similar findings were reported previously for the association between OA and cardiovascular comorbidities 15,16 , while a bit higher estimate was found in a US population with radiographic knee OA 17 . There seem not to be a simple explanation of the apparent differential effect of OA on different cardiovascular outcomes.…”