High cardiovascular risk in inflammatory joint diseases

Risk factors for cardiovascular disease are often present in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis, according to Grunde Wibetoe‘s research. Few patients receive adequate treatment.


MAIN RESULTS:

  1. Patients with rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis have similar cardiovascular risk.
  2. Many patients with inflammatory joint diseases have a higher cardiovascular “risk age” than their actual age.
  3. Few patients attain treatment goals for blood pressure and cholesterol.

THESIS DEFENCE:

Thesis: Cardiovascular disease risk in inflammatory joint disease: Conventional disease risk factors across inflammatory joint diseases and performance of risk age models in rheumatoid arthritis
Candidate: Grunde Wibetoe
Time: February 8 at 13:15
Place: Diakonhjemmets Høgskole: Lower and upper auditorium
Link to university website


SUMMARY:

(1) Almost three out of four patients with inflammatory joint diseases have at least one of the traditional risk factors for cardiovascular disease. Half of those without cardiovascular disease had high blood pressure and a third had high cholesterol levels.

A total of 3,791 patients with either rheumatoid arthritis, psoriatic arthritis or axial spondyloarthritis were included in the analyses. The prevalence of cardiovascular risk factors was similar in the three groups. 274 of the patients had cardiovascular disease.

(2) Patients with inflammatory joint disease and apparently low 10-year risk of cardiovascular disease, might still have considerably higher risk than patients with optimal levels of all cardiovascular risk factors. Furthermore, a substantial amount of patients have a “risk age” at least five years higher than their actual age.

The study includes 1,826 patients with inflammatory joint disease considered to have less than 5 % 10-year risk of cardiovascular disease according to the SCORE calculator.

(3) Treatment with statins and antihypertensives are frequently indicated in inflammtory joint disease, but few receive adequate treatment.

(4) Wibetoe and colleagues have also demonstrated comparable predictive ability of the cardiovascular risk age and vascular age models. Yet, the different models need to be validated before use in clinical practice, as they could yield highly discrepant results on the individual level.


REFERENCES:

(1) Wibetoe, G., Ikdahl, E., Rollefstad, S., Olsen, I. C., Bergsmark, K., Kvien, T. K., Salberg, A., Soldal, D. M., Bakland, G., Lexberg, Å., Fevang, B-T., Gulseth, H. C., Haugeberg, G., & Semb, A. G. (2017). Cardiovascular disease risk profiles in inflammatory joint disease entitiesArthritis research & therapy19(1), 153.

(2) Wibetoe, G., Ikdahl, E., Rollefstad, S., Olsen, I. C., Bergsmark, K., Kvien, T. K., Salberg, A., Soldal, D. M., Bakland, G., Lexberg, Å., Fevang, B.-T., Gulseth, H. C., Haugeberg, G., & Semb, A. G. (2018). Discrepancies in risk age and relative risk estimations of cardiovascular disease in patients with inflammatory joint diseasesInternational Journal of Cardiology252, 201-206.

(3) Ikdahl, E., Wibetoe, G., Rollefstad, S., Salberg, A., Bergsmark, K., Kvien, T. K., Olsen, I. C., Soldal, D. M., Bakland, G., Lexberg, Å., Fevang, B. T., Gulseth, H. C., Haugeberg, G. & Semb, A. G. (2019) Guideline recommended treatment to targets of cardiovascular risk is inadequate in patients with inflammatory joint diseases. International journal of cardiology274, 311-318.

(4) Wibetoe, G., Sexton, S., Ikdahl, E., Rollefstad, S., Kitas, G. D., van Riel, P., Gabriel, S., Kvien, T. K., Douglas, K., Sandoo, A., Arts, E. A., Wållberg-Jonsson, S., Dahlquist, S. R., Karpouza, GB., Dessein, P. H. Tsang, L., El-Gabalawy, H., Hitchon, C. A., Pascual-Ramos, V., Contreas-Yanes, I., Sfikakis, P., Ganzalez-Gay, M., Colunga-Pedraz, I. J., Galarza-Delgado, D. A., Azpiri-Lopez, J. R., Crowson, C. S., & Semb, A. G. Prediction of  cardiovascular events in rheumatoid arthritis using risk age calculations: Evaluation of concordance across risk age models. [submitted].