Racial Disparities in Cardiovascular Events from Rheumatoid Arthritis

Connective tissue disease (CTD) groups together various disorders, such as rheumatoid arthritis and lupus. A new study from the University of Chicago found that complications from these diseases are more prominent based on race.

It’s been well-established that patients with rheumatoid arthritis and psoriatic arthritis have an increased risk for cardiovascular problems. However, study author Francis Alenghat, MD, PhD, explained that there was scarce information on the relationship between race and CTD when it came to cardiovascular risk.

Alenghat analyzed records from more than 287,000 Caucasian and African American patients who were treated at the university’s medical center, as described in Scientific Reports. Of those, 8.4% of Caucasians and 10% of African Americans had atherosclerotic cardiovascular disease, which is the build-up of fats and cholesterol in the artery walls, and defined as heart attack, ischemic heart disease, angina, coronary artery disease, or atherosclerotic disease of any artery. These conditions can lead to heart attack, stroke, and death.

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When it came to patients with CTD, defined as rheumatoid arthritis, lupus, scleroderma, or dermatomyositis, there was a strong correlation with cardiovascular events. A total of 8,747 patients had CTD and of those, nearly 15% of Caucasians and 30% of African Americans also had atherosclerotic cardiovascular disease. Needless to say, African Americans had a significantly higher risk of cardiovascular events and it was especially recognized in the younger patients.

“These findings raise new questions about the links between inflammation, connective tissue diseases, and atherosclerotic cardiovascular disease,” Alenghat, assistant professor of medicine in the section of cardiology at the University of Chicago, said in a news release.

This information may change the way that physicians evaluate their patients. Based on the findings, Alenghat suggests that “we should consider lower thresholds for primary prevention in many patients with CTD,” Alenghat continued.

Not only does the data indicate that race is a key factor in cardiovascular risk, but age as well.

“If we were to view the current findings on the backdrop of contemporary cardiovascular risk calculators and statin guidelines, many patients with connective tissue disease could reasonably consider moderate-intensity statin therapy at age 35,” Alenghat conluded.

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