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In a recent
issue of The Johns Hopkins
arthritis Bulletin, Johns Hopkins specialists
reported on the latest research regarding the link between
rheumatoid arthritis and heart health.
With rheumatoid arthritis, the inflammation
that damages joints also takes a toll on the heart. Johns Hopkins
specialists offer bottom line advice on how to adopt a heart-healthy
lifestyle to combat the effects of rheumatoid arthritis (Rheumatoid Arthritis) and its
accompanying inflammation.
BEING HEART-SMART WITH RA
People with rheumatoid arthritis understandably focus on caring for
their joints. But their most serious health risk involves their heart.
Compared to the general population,
rheumatoid arthritis patients have a significantly increased risk of
heart attack and stroke, and a shorter life expectancy.
Rheumatoid Arthritis AND YOUR HEART: THE RISKS
Here are some of the findings from recent studies about the link between
rheumatoid arthritis and heart disease:
-
Heart
attacks are twice as common among women with
rheumatoid arthritis as
among those without the disease.
-
Atherosclerosis ("hardening of the arteries") starts early and
progresses more rapidly in people with
rheumatoid arthritis.
-
Carotid artery blockages (a risk factor for stroke) are three times
more common in people with
rheumatoid arthritis
than in people
without the disease (44% vs. 15%).
-
Cardiovascular events, such as heart attack and stroke, occur about
10 years earlier in people with
rheumatoid arthritis.
-
Mortality is higher among
rheumatoid arthritis
patients after a
first heart attack.
-
Blood
vessel damage is often already apparent at the time of
rheumatoid arthritis diagnosis.
-
Heart
attacks in rheumatoid arthritis patients are more likely to be
silent or to occur without the typical symptoms, and they more often
result in sudden cardiac death.
-
Congestive heart failure (weakening of the heart's pumping ability)
is more common among people with
rheumatoid arthritis.
Researchers have identified
several links between
rheumatoid arthritis and cardiovascular disease.
Inflammation is believed to be the most important of these.
THE ROLE OF INFLAMMATION IN
ATHEROSCLEROSIS
Cardiologists now understand that inflammation plays a crucial role in
the onset of atherosclerosis. They believe that an injury to the inner
lining of the arteries (the endothelium) triggers an immune response,
sending immune system cells rushing to repair the damage.
THE EFFECTS OF CHRONIC
INFLAMMATION ON YOUR ARTERIES
But in chronic inflammatory states such as rheumatoid arthritis, the
immune response doesn't shut off after the injury heals. The
accumulating immune system cells attract deposits of cholesterol, blood
platelets, cellular debris, and calcium, which clump together to form
plaque.
As plaque deposits grow, they
restrict blood flow through the artery. If the plaque ruptures, clots
can break away and travel to the heart or brain, where they may cause a
heart attack or a stroke.
BOTTOM LINE ADVICE: WHAT CAN
YOU DO TO STAY HEART-SMART EVEN IF YOU HAVE RHEUMATOID ARTHRITIS
The relationship between rheumatoid arthritis and the heart is complex,
and rheumatologists still have a great deal to learn about how to reduce
the risk of cardiovascular disease among people who have
rheumatoid
arthritis.
For now, it's important to do
everything possible to reduce the traditional risk factors for heart
disease and stroke:
smoking,
obesity, a sedentary lifestyle, high blood pressure, high
cholesterol, and
diabetes.
Getting regular exercise and
losing extra pounds (even a 5-10% weight reduction is beneficial) will
help your joints as well as your heart. Monitor your blood pressure and
have your cholesterol levels checked regularly.
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Rheumatoid Arthritis and Your Heart
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