RA and "Random" Heart Attacks

Sufferers of rheumatoid arthritis (RA) have long been known to be particularly at risk for heart disease. However, the findings of a new study suggest that people suffering from RA are struck with unpredictable heart attacks. These cardiac arrests tend to be more silent and unrecognized, and at times result in sudden cardiac deaths.

Often the risk of heart attack is already present at the time a patient is diagnosed with RA. But according to the study conducted by Hilal Maradit Kremers et al. at the Mayo Clinic, the risk of heart disease may even be present years before the diagnosis of rheumatoid arthritis. The study itself consisted of a group of 603 Rochester, Minnesota residents diagnosed with rheumatoid arthritis between Jan. 1, 1955 and Jan. 1, 1995. Data about health history and current conditions of the patients (especially past cardiac events, blood pressure, cholesterol, body mass index, etc.) were then compared with data collected on 603 Rochester residents of the same ages and gender without rheumatoid arthritis. Both the patients and the comparison subjects were followed up for a median of 26 years before rheumatoid arthritis diagnosis and 15 years after diagnosis.

According to the study, during the two years before diagnosis of rheumatoid arthritis, patients with this disease were three times more likely to have been hospitalized for an acute heart attack and five times more likely to have an unrecognized heart attack. Strangely enough, they were also less likely to have had a history of chest pain. After being diagnosed, rheumatoid arthritis patients were twice as likely to experience unrecognized heart attacks and sudden cardiac deaths.

So far researchers have yet to understand the connection between RA and this form of heart disease. In this study, the researchers were unable to explain the increased cardiac events in rheumatoid arthritis patients. Although traditional heart disease risk factors, such as elevated cholesterol, blood pressure and body mass index, diabetes, and alcohol abuse, are important considerations for RA patients, they appear to be less important compared to non-RA sufferers. As Dr. Maradit Kremers put it, "Something else is going on. It could be that rheumatoid arthritis and heart disease have a common origin. What we do know is that the cause cannot be explained by just one factor. It is multifactorial." One hypothesis given by the group was that the systemic inflammation characterized by RA also promotes this silent form of cardiovascular disease. The goal of future research in this area is to unravel the complex relation between the two diseases.

Not all hope is lost for RA sufferers though. Regular cardiac checkups are especially important, as is lowering traditional cardiac risk factors, such as taking care of blood pressure and cholesterol and quitting smoking. Until more is known about the connection between RA and heart disease, traditional risk factors are the only thing RA sufferers can work on.

Article References
http://www.mayoclinic.org/news2005-rst/2654.html, site accessed on 06/14/05