title: Rheumatoid arthritis is an independent risk factor for an increased augmentation index regardless of the coexistence of traditional cardiovascular risk factors.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity. It was previously shown that the augmentation index (AIx), a marker of vascular dysfunction, is higher in RA patients without traditional cardiovascular risk factors than in healthy controls. In this study we determined whether the impact of RA on the AIx is diminished in the context of coexisting, strong cardiovascular risk factors.
  
  
  METHODS
  A total of 411 participants were included [203 with RA; 208 in the non-RA (n-RA) group]. Pulse-wave analysis was performed on the radial artery using applanation tonometry. The impact of RA on the AIx was determined in a single and in a multiple linear regression model.
  
  
  RESULTS
  The mean unadjusted AIx was 30.5 ± 9.0% for RA patients and 24.0 ± 11.0% for the n-RA group (P < 0.001). In the regression model, the following variables are statistically significant at approximately the same level (P < 0.001); the order of impact of these variables is age > diastolic blood pressure > sex > RA > height > smoking status. RA, height, and smoking had a nearly equal impact on the AIx.
  
  
  CONCLUSIONS
  The AIx is increased in RA patients regardless of the coexistence of traditional cardiovascular risk factors, thereby reflecting vascular dysfunction in this population. The impact of RA on the vascular system is comparable to that of smoking.
authors.affiliation: Section of Rheumatology, 2nd Department of Medicine, General Hospital Linz, Linz, Austria. herwigpi@yahoo.com
authors.forename: Herwig
authors.initials: H
authors.lastname: Pieringer
authors.forename: Tobias
authors.initials: T
authors.lastname: Brummaier
authors.forename: Michael
authors.initials: M
authors.lastname: Schmid
authors.forename: Max
authors.initials: M
authors.lastname: Pichler
authors.forename: Avida
authors.initials: A
authors.lastname: Hayat-Khayyati
authors.forename: Stefan
authors.initials: S
authors.lastname: Ebner
authors.forename: Georg
authors.initials: G
authors.lastname: Biesenbach
authors.forename: Erich
authors.initials: E
authors.lastname: Pohanka
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D017534:Radial Artery / Q000473:pathology / Q000503:physiopathology*; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents