title: Association between polymyalgia rheumatica and vascular disease: a systematic review.
abstract: OBJECTIVE
  To systematically identify and appraise the existing literature on the association between polymyalgia rheumatica (PMR) and vascular disease.
  
  
  METHODS
  The Medline, Embase, CINAHL, and Cochrane databases were searched from inception to September 2010. Search criteria included observational studies containing patients with isolated PMR reporting on a vascular outcome. Data were extracted and articles were assessed for quality.
  
  
  RESULTS
  The database search identified 545 articles. Eight articles reporting on 7 unique studies were included in the final review. Four studies reported on vascular mortality and 3 studies reported on other vascular outcomes. Four of the studies reported statistically significant positive associations between PMR and vascular disease and 3 studies reported no statistically significant results. The heterogeneity of the results was investigated; the strongest explanatory variable was that 2 of 3 studies that reported nonsignificant results were prospective, whereas all of those studies reporting significant results were retrospective.
  
  
  CONCLUSIONS
  There is some evidence to suggest that, like other inflammatory rheumatic disorders, PMR may be linked to an increased risk of vascular disease. Further studies are required to quantify the level of risk to determine whether patients with PMR should be actively screened for cardiovascular disease and its risk factors.
authors.affiliation: Arthritis UK Primary Care Centre, Keele University, Stoke-on-Trent, UK. athancock@doctors.org.uk
authors.forename: Adam T
authors.initials: AT
authors.lastname: Hancock
authors.forename: Christian D
authors.initials: CD
authors.lastname: Mallen
authors.forename: John
authors.initials: J
authors.lastname: Belcher
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Hider
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011111:Polymyalgia Rheumatica / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D014652:Vascular Diseases / Q000453:epidemiology* / Q000401:mortality