[How to evaluate the cardiovascular and renal risk at the individual level?].
The cardiovascular impact of the non-steroidal anti-inflammatory drugs and the higher cardiovas-cular mortality during treatment of inflammatory rheumatism impose a rigorous evaluation of the cardiovascular risk of rheumatic patients. Large epidemiological studies have identified risk factors for cardiovascular diseases such as the age, male gender, family history (infarct, stroke), tobacco consumption, systolic arterial pressure, renal insufficiency, hypercholesterolemia, diabetes mellitis, sedentariness, obesity and "electric" ventricular hypertrophy. Some equations make it possible to evaluate the absolute cardiovascular risk at the individual level, which corresponds to the onset risk of a stroke in the 10 years to come in a subject according to the number and importance of each of his risk factors. It has been demonstrated that the correction of one or more risk factors reduce the overall cardiovascular risk, justifying the strategies for evaluating this risk to define therapeutic intervention thresholds. The impact of a long-term anti-inflammatory treatment or an inflammatory disease such as rheu-matoid arthritis has not been the subject of specific epidemiological study allowing these elements to be included in an equation of the estimation of the cardiovascular risk. However, the introduction of an anti-inflammatory treatment, likely to increase the cardiovascular risk of a patient, certainly justifies an evaluation of the absolute cardiovascular risk.
Schaeverbeke
Thierry
T
Service de Rhumatologie, CHU Pellegrin, Bordeaux.
Vicaut
Eric
E
Cohen
Ariel
A
Ravaud
Philippe
P
D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D012216:Rheumatic Diseases / Q000175:diagnosis*; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal