Rheumatoid Arthritis Guilty for Myocardial Episodes

Rheumatoid arthritis nearly doubles the risk of heart attack within the first decade of diagnosis, according to the American College of Rheumatology. The good news for sufferers is that the adoption of a "friendly" to heart lifestyle, combined with proper medication, can protect them.
 
The rheumatologist Dimitris Qasim, head physician at General 401 General Military Hospital, explains where the relationship is and what it should do the sick.

How does rheumatoid arthritis cardiovascular risk?

Long-term epidemiological studies in Europe and the U.S. have shown that accelerates atherosclerosis in the blood vessels of the heart and brain, leading to manifest cardiovascular events (heart attack, stroke), about a decade earlier than what the general population.

However, it can occur even in people with disease duration less than two years. In fact rheumatoid arthritis increases the risk of ischemic heart disease by 50% one to four years after diagnosis - and the risk remains high for the next 5-12 years.

He found that the risk associated with other problems that may have patients, such as hypertension, obesity, smoking, etc. if

Why is that?

The exact mechanism of association is unknown, but it seems to involve a variety of substances, such as tumor necrosis factor (TNF-a), which plays a crucial role in immune and inflammatory mechanisms of rheumatoid arthritis.

Studies have also shown that the presence of elevated levels of the protein CRP (C-reactive protein) in the blood of patients with rheumatoid arthritis is the likelihood cardiovascular event, and when present in the blood of certain antibodies (antikitroulinika or anti-CCP-2) seems that it doubles the risk of cardiovascular disease.

Increased risk observed when elevated levels of the amino acid homocysteine.

How can a patient know if the inflammation is out of control?

Making self-assessment of disease as experienced in everyday life, with the completion of the "diary" of rheumatoid arthritis provided to patients, and with regular monitoring by the rheumatologist.

Patients need systematic checkup of the heart?

The cardiac health of patients with rheumatoid arthritis assessed at the first clinical examination, then certainly once a year as recommended by the Standards of Care for People with Rheumatoid Arthritis, which were drafted in the 1st Meeting of Associations of Persons with Rheumatic Diseases in October of 2012.

There are risk factors that the burden?

Smoking is positively associated with the third of the most severe forms of rheumatoid arthritis and in 50% of cases that are genetically predisposed to develop it. Also related to the presence of positive citrulline antibodies.

What should I do to protect themselves?

Recommended changes in lifestyle, such as regular physical activity (eg walking, water exercise, swimming, dancing, tai-chi, yoga, pilates), healthy eating and smoking cessation.

Antirheumatic drugs affect the risk for heart attack?

To protect against cardiovascular event needed is early initiation of treatment recommended by the rheumatologist and regular monitoring. If you already have heart disease requires close collaboration rheumatologist and cardiologist.

There is a potential long-term corticosteroid use increases the chance for cardiovascular event, although in some studies appeared to act contrary (protective). The use of classic nosotropopoiitikon (eg methotrexate, leflunomide, sulfasalazine) and biological factors appear to reduce the incidence of cardiovascular events.

Numbers

About 100,000 Greeks and Greeks suffer from rheumatoid arthritis

3 times more women than men patients

35-55 years of age the most common manifestation.

30-60% of patients develop myocardial

What is

Rheumatoid arthritis einaichronia disease that causes pain, morning stiffness and swelling resulting in the restriction of mobility and reduced quality of life.

Target Organs

The joints are the main target of rheumatoid arthritis, but may manifest complications in other organs (skin, eyes, lungs, heart, blood vessels, nerves, blood).

Rheumatoid arthritis is in autoimmune diseases, namely caused by a dysfunction of the immune system, the challenge of which appear to play a role many factors (environmental, genetic, hormonal).

Comorbidity harmful to heart

It has been found from clinical studies that patients with rheumatoid arthritis often experience other problems that increase the risk for heart attack:

14% have high cholesterol

33% have hypertension

8% have diabetes

18% are obese

43% are smokers

72% do not exercise

Additional charges also cause hypothyroidism, family history of cardiovascular problems, exoarthrikesekdiloseis (eg subcutaneous nodules, vasculitis, damage lung scleritis). Other risk factors are male sex (doubled risk), advanced age and makrochroniakathimerini chrisiantiflegmonodon.

Tip

For any medication or alternative therapy in a patient suggested for prevention of cardiovascular events, it is necessary the advice of rheumatologist and cardiologist before using.

Date: 11-04-2013

Source: ΤΑΝΕΑ