Experts say doctors should evaluate rheumatoid arthritis patients and others for an increased risk of heart disease.
Several new studies from the Mayo Clinic show a strong connection between inflammation and heart health, emphasizing the importance of addressing both conditions at the same time.
Dr. Eric Matteson, chair of rheumatology at the Mayo Clinic, says that people with rheumatoid arthritis (RA) and other chronic inflammatory conditions are at a much higher risk of heart disease. In fact, people with severe RA are twice as likely to develop heart disease.
“We’re quite certain this has to do with the inflammatory process of arthritis,” Matteson told Healthline. He presented numerous studies from Mayo this weekend during the American College of Rheumatology’s annual meeting in San Diego, Calif.
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The full biological impact of chronic inflammation in conditions like RA, psoriasis, psoriatic arthritis, and lupus is still not fully understood. Some research has shown that mood disorders like depression are also related to chronic inflammation.
Even with all risk factors considered, researchers found that the severity of certain inflammatory conditions can drastically increase a person’s likelihood of developing heart problems later in life.
Researchers discovered that the burden RA puts on the joints during the first year of diagnosis is a strong predictor of heart disease. Doctors who diagnose patients with RA should use this time to address potential heart risks in the future, Matteson said.
Another study examined the relationship between RA and cytomegalovirus (CMV), a type of herpes virus that typically goes unnoticed in healthy people. Mayo researchers found that a relationship between the two exists, and that CMV, too, affects the heart.
The virus puts patients at a greater risk for myocardial disease, a type of heart disease in which the heart muscle becomes progressively weaker. The relationship should prompt doctors to check for biomarkers of CMV in RA patients to assess their risk of heart problems, Dr. Matteson, a co-author on that study, said.
“This is something that is not well-recognized,” he added.
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A third study from Mayo researchers shows that psoriasis and psoriatic arthritis patients are also at a higher risk of developing heart disease, but not to the same extent as those with RA, Matteson said.
“Again, we think it’s related to inflammation,” he said.
Women with RA who go through menopause before age 45, in what is called early menopause, also appear to have a higher risk of developing heart disease, one study showed.
Women run a much lower risk of heart disease than men until menopause, when their risks become equal. Researchers believe that this is due to the protective effects of estrogen, a hormone that decreases after menopause. About two-thirds of RA patients are women.
“This study shows the complex relationship between rheumatoid arthritis, hormones, and hear disease,” Matteson said. “We also found patients who have had multiple children, especially seven or more, are at higher risk of cardiovascular disease compared with women who have menopause at a normal age or have fewer children.”
All of the new studies point to one thing, Matteson said: “Doctors should be sending patients for heart evaluations they might not have previously thought to do. We think this is a very important issue.”