Managing Cardiovascular Disease Risk in Rheumatoid Arthritis: Clinical Updates and Three Strategic Approaches

Curr Rheumatol Rep. 2017 Apr;19(4):16. doi: 10.1007/s11926-017-0643-y.

Abstract

ᅟ: The increase in cardiovascular disease (CVD) risk in rheumatoid arthritis (RA) is well known; however, appropriate management of this elevated risk in rheumatology clinics is less clear.

Purpose of review: By critically reviewing literature published within the past 5 years, we aim to clarify current knowledge and gaps regarding CVD risk management in RA.

Recent findings: We examine recent guidelines, recommendations, and evidence and discuss three approaches: (1) RA-specific management including treat-to-target and medication management, (2) assessment of comprehensive individual risk, and (3) targeting traditional CVD risk factors (hypertension, smoking, hyperlipidemia, diabetes, obesity, and physical inactivity) at a population level. Considering that 75% of US RA visits occur in specialty clinics, further research is needed regarding evidence-based strategies to manage and reduce CVD risk in RA. This review highlights clinical updates including US cardiology and international professional society guidelines, successful evidence-based population approaches from primary care, and novel opportunities in rheumatology care to reduce CVD risk in RA.

Keywords: Cardiovascular disease; Hyperlipidemia; Hypertension; Rheumatoid arthritis; Risk assessment; Smoking cessation.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / prevention & control
  • Disease Management
  • Evidence-Based Medicine / methods
  • Humans
  • Risk Assessment / methods
  • Risk Factors
  • Risk Management / methods

Substances

  • Antirheumatic Agents