title: Prevalence of traditional modifiable cardiovascular risk factors in patients with rheumatoid arthritis: comparison with control subjects from the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  Despite the recognized risk of accelerated atherosclerosis in patients with rheumatoid arthritis (RA), little is known about cardiovascular risk management in contemporary cohorts of these patients. We tested the hypotheses that major modifiable cardiovascular risk factors were more frequent and rates of treatment, detection, and control were lower in patients with RA than in non-RA controls.
  
  
  METHODS
  The prevalence of hypertension, diabetes, elevated low-density lipoprotein (LDL) cholesterol, elevated body mass index, smoking, moderate-high 10-year cardiovascular risk and the rates of underdiagnosis, therapeutic treatment, and recommended management were compared in 197 RA patients and 274 frequency-matched control subjects, and their associations with clinical characteristics were examined.
  
  
  RESULTS
  Eighty percent of RA patients and 81% of control subjects had at least 1 modifiable traditional cardiovascular risk factor. Hypertension was more prevalent in the RA group (57%) than in controls [42%, P = 0.001]. There were no statistically significant differences in the frequency of diabetes, elevated body mass index, smoking, intermediate-high 10-year coronary heart disease risk, or elevated LDL in patients with RA versus controls. Rates of newly identified diabetes, hypertension, and hyperlipidemia were similar in RA patients versus controls. Rates of therapeutic interventions were low in both groups but their use was associated with well-controlled blood pressure (OR = 4.55, 95% CI: 1.70, 12.19) and lipid levels (OR = 9.90, 95% CI: 3.30, 29.67).
  
  
  CONCLUSIONS
  Hypertension is more common in RA than in controls. Other traditional cardiovascular risk factors are highly prevalent, underdiagnosed, and poorly controlled in patients with RA, as well as controls.
authors.affiliation: Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA. c.chung@Vanderbilt.Edu
authors.forename: Cecilia P
authors.initials: CP
authors.lastname: Chung
authors.forename: Jon T
authors.initials: JT
authors.lastname: Giles
authors.forename: Michelle
authors.initials: M
authors.lastname: Petri
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Wendy
authors.initials: W
authors.lastname: Post
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Allan C
authors.initials: AC
authors.lastname: Gelber
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Jenny
authors.forename: Joan M
authors.initials: JM
authors.lastname: Bathon
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000097:blood / Q000453:epidemiology
chemical_list: D008078:Cholesterol, LDL