Increased Risk Of Cardiovascular Disease in Stressed Rheumatoid Arthritis Patients

A new study reveals that lack of social support, stress, anxiety, anger and depressive symptoms in people suffering from rheumatoid arthritis (RA) can be linked to atherosclerosis and lead to cardiovascular disease. Atherosclerosis is a build-up in the arteries of fatty deposits.

The new study was published in the journal of the American College of Rheumatology (ACR), Arthritis Care & Research. The research paper suggests that it would be necessary to implement more screening and treatment of psychosocial symptoms in order to minimize the risks of the cardiovascular disease burden in rheumatoid arthritis patients.

According to the Centers for Disease Control and Prevention, around 1.5 million Americans suffer of RA. This is a form of an autoimmune disease that manifests through the joint stiffness, swelling and pain, along with fatigue. Some previous studies have also shown already that, compared with the general population, cardiovascular disease is more prevalent in RA patients. Cardiovascular disease also contributes to greater mortality in this patient group. However, up to date the reasons for the increased risk of heart disease in patients with RA are still unknown.

According to Assistant Professor of Medicine at Columbia University, and lead investigator in the study, Dr. Jon Giles, it is important to understand the risk factors contributing to greater mortality in patients with chronic conditions. The study of the team of researchers led by Dr. Giles is the first to investigate the association between elevated risk of atherosclerosis in RA patients and psychosocial co-morbidities.

The research has used data from the Evaluation of Subclinical Cardiovascular Disease and Predictors of Events in Rheumatoid Arthritis Study (ESCAPE). ESCAPE data analyzed the prevalence, progression and risk factors for cardiovascular disease in RA patients. The team of researchers examined the data from a cohort including 1,073 controls without RA and 195 RA patients. The participants underwent an ultrasound and computed tomography to measure the carotid artery thickness, levels of coronary artery calcium (CAC) and plaque build-up in order to determine the degree of atherosclerosis.

According to the results of the analysis anger and higher anxiety, stress and depression were associated with higher risk of CAC greater than 100 units in patients with RA, which represents moderate to severe disease. The team also found that job stress in RA patients leads to an increased risk of carotid plaque. On a contrary, increasing social support was found to lower carotid intima-media thickness in patients with RA.

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