As our ability to control inflammation and pain in Rheumatoid arthritis has improved, we’ve started to realize that our patients have other issues that they are at risk for. Cardiovascular disease is elevated in RA, and is a serious issue that has been neglected in our patients. The theory goes that chronic inflammation in RA leads to inflammation in the blood vessels and atherosclerotic plaques, which are then more prone to occluding and causing heart attacks and strokes. So what can we do about this?
First and foremost understand that cardiovascular disease is a major problem in Rheumatoid arthritis. That means we should be aiming for ideal blood pressure, blood sugar, and cholesterol levels. Focusing on healthy dietary choices and regular exercise is essential. It can’t be something we think about abstractly, it means concrete steps and goals should be sought after.
Another attractive idea is whether controlling inflammation with RA medications can prevent cardiovascular disease risk in the future. That hasn’t been definitively proven, but as a theory it makes sense. It fits with the concept that RA is a systemic condition that affects more than joints alone. It also fits with the paradigm of treating RA early and aggressively.
Anti-inflammatory supplements should be considered as well. I generally recommend for all my RA patients to use omega 3. Omega 3 has been shown to help with inflammation and pain in RA. In addition it has the potential for reducing cardiovascular risk in the general population.
RA patients have more heart disease than the general population. Now that we recognize the problem, let’s do something about it.