Cardiovascular and cerebrovascular diseases in ankylosing spondylitis: current insights.
Patients with ankylosing spondylitis (AS) suffer from an increased cardiovascular (CV) risk. The evidence for increased atherosclerotic disease is nowadays convincing, while the precise contribution of the so-called AS-specific (related) cardiac manifestations toward the increased CV risk still needs to be determined. Such studies should be performed in the near future, since they might have clinical consequences-for example, mandatory echocardiographic screening of AS patients. There appears to be a clear contribution of the "traditional" CV risk factors, as well as the underlying chronic inflammatory process, to the increased atherosclerotic risk in AS. Furthermore, there is accumulating evidence for an etiological role of inflammation in the AS-related cardiac manifestations. Nowadays, CV risk management appears necessary for AS patients, and this should consist of, on the one hand, assessment and treatment, if necessary, of the "traditional" CV risk factors, and, on the other hand, effective suppression of the inflammatory process.
Department of Internal Medicine, VU University Medical Centre, PO Box 7057, Amsterdam, The Netherlands. mt.nurmohamed@vumc.nl
Michael T
MT
Nurmohamed
Irene
I
van der Horst-Bruinsma
Walter P
WP
Maksymowych
D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D057210:Delayed Diagnosis; D006801:Humans; D007249:Inflammation; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D012308:Risk Management; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000453:epidemiology*; D015996:Survival Rate