title: Cardiovascular disease is related to hypertension in patients with rheumatoid arthritis: a greek cohort study.
abstract: OBJECTIVE
  To evaluate the incidence of cardiovascular disease (CVD) among Greek patients with rheumatoid arthritis (RA) under medical followup, and to assess the contribution of traditional CVD and RA-specific factors associated with CVD development.
  
  
  METHODS
  This is a historic cohort study; information was collected from medical records of patients who had > 2 years' followup. Sociodemographic, clinical, laboratory, and therapeutic variables were evaluated for association with development of CVD.
  
  
  RESULTS
  A total of 325 RA patients were studied: 250 women, mean age at RA onset 44 ± 15 years, and 75 men, mean age at RA onset 51 ± 15 years; median followup was 10 years. Fourteen women (5.6%) and 12 men (16%) developed CVD (p = 0.004). Multi-adjusted analysis revealed that hypertension (hazard ratio 3.76, 95% CI 0.99-15.06) was associated with incidence of CVD; late age at disease onset (HR 1.07, 95% CI 1.04-1.11), elevated C-reactive protein (CRP) level 1 year after start of followup (HR 1.03, 95% CI 1.00-1.05), and leflunomide treatment (HR per 1 year of treatment = 1.02, 95% CI 1.00-1.05) were also positively associated with CVD development.
  
  
  CONCLUSIONS
  Hypertension was an important risk factor for CVD development in patients with RA. Late RA onset and inadequate early control of disease activity (as attested by CRP) remain additional risk factors. Leflunomide treatment may have a contributing effect. Early and effective treatment of RA and strict control of hypertension may modify the burden of CVD in RA patients.
authors.affiliation: Athens Euroclinic, 7 Athanasiadou Str., Athens, 11521 Greece.
authors.forename: John
authors.initials: J
authors.lastname: Serelis
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.forename: Maria
authors.initials: M
authors.lastname: Mavrommati
authors.forename: Fotini N
authors.initials: FN
authors.lastname: Skopouli
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors