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Rheumatoid arthritis (RA) is an autoimmune form of arthritis that affects more than just your joints. It can also affect other tissues and organs, and it may cause problems in the heart.

However, just because you have RA doesn’t mean you’ll inevitably have issues with your heart. There are steps you can take to keep your heart healthy and avoid developing heart disease.

Read on to find out the connection between RA and heart disease and how you can lower your risk factors for developing heart disease if you’re living with RA.

Rheumatoid arthritis is an autoimmune form of arthritis. Autoimmune means that your immune system overreacts and attacks otherwise healthy cells by mistake. When this happens, it causes chronic swelling and inflammation that can lead to pain and deformity in the affected areas.

RA normally affects the joints in the following areas:

  • hands
  • wrists
  • knees

Chronic inflammation from RA can affect other areas of the body besides the joints. It can also lead to problems with the heart, lungs, and eyes.

Chronic inflammation from RA increases the risk of heart disease. Inflammation damages the blood vessels and can cause plaque to build in the arteries. Plaque in the arteries can narrow the blood vessels and block blood flow, leading to heart attack or stroke.

Proteins called cytokines are linked to the growth and activity of other immune system cells. These proteins are responsible for both the way RA attacks the joints and the way it damages blood vessels in cardiovascular disease.

Inflammation isn’t the only link between RA and heart disease. Many of the risk factors for RA are the same as the risk factors for heart disease.

Risk factors for both RA and heart disease include:

High blood pressure

If you have RA, your blood pressure is likely to be higher due to:

  • lack of exercise
  • certain medications that treat RA, like steroids
  • less elastic arteries

Inflammation is also linked to higher blood pressure. People with RA may have 10 times the amount of inflammation as a person who doesn’t have RA.


Having obesity may be linked to the risk of developing RA.

While researchers don’t know for sure how the two are linked, the Arthritis Foundation notes that the sore joints associated with RA can make it hard to exercise, and lack of exercise can cause weight gain.

Additionally, obesity is associated with inflammation and other risk factors for heart disease including high blood sugar and high blood pressure.

Obesity is also linked to metabolic syndrome. Metabolic syndrome is a group of symptoms that include other risk factors that raise the risk of heart disease including:

  • high triglycerides and cholesterol
  • high blood pressure
  • high blood sugar

Metabolic syndrome is twice as common in people with RA compared to people who don’t have RA.

Lipid paradox

RA affects the fats in the blood in a unique way. People with RA generally have:

  • low levels of LDL (“bad” cholesterol)
  • high levels of triglycerides
  • low levels of HDL or (“good” cholesterol)

While having low levels of LDL is associated with heart health, having too little good cholesterol and high triglycerides can increase the risk of heart disease.


People who smoke are more likely to develop RA than people who do not smoke. If you smoke and have RA, you’re more likely to have more severe RA than someone who doesn’t smoke.

Not only does smoking increase the risk of developing RA or having more severe joint damage from RA, but it’s also a major cause of heart disease according to the Centers for Disease Control and Prevention (CDC). A person that smokes and has RA is 50 percent more likely to develop heart disease than a person who doesn’t smoke and has RA.

Even though RA increases the risk of heart disease, you can work with your doctor to lower your risk.

One of the easiest ways to protect yourself from heart disease related to RA is taking the medications your doctor prescribes to control the inflammation from RA. Disease-modifying antirheumatic drugs (DMARD) reduce the inflammation associated with RA and may reduce the risk of heart disease.

Though people living with RA have an increased risk of heart disease, medical guidelines in the United States don’t have specific recommendations to reduce heart disease if you have RA. However, the current European League Against Rheumatism (EULAR) recommends you should be screened every 5 years for risk factors of heart disease.

You can also make some lifestyle changes to help lower your risk of heart disease. The American Heart Association suggests the following tips to reduce the risk of heart disease:

  • eating a balanced diet of vegetables, fruits, and whole grains
  • getting at least 150 minutes of aerobic exercise per week
  • maintaining a moderate weight
  • avoiding smoking or quitting
  • managing any health conditions like RA that raise your risk of heart disease
  • taking any medication prescribed by a doctor to prevent heart disease, like statins

RA increases the risk of developing heart disease due to inflammation and shared risk factors. Though there’s an increased risk, you can take steps to lower the chances of developing heart disease even if you’re living with RA.