title: Disability and not osteoarthritis predicts cardiovascular disease: a prospective population-based cohort study.
abstract: BACKGROUND
  Previous studies found an association between osteoarthritis (OA) and risk of cardiovascular disease (CVD) and therefore suggested intensive treatment of cardiovascular risk factors in OA patients. However, prospective population-based data is lacking.
  
  
  OBJECTIVE
  To investigate the association between OA and CVD longitudinally in a general population and examine the role of disability in this association.
  
  
  METHODS
  This study was embedded in the Rotterdam Study, a prospective population-based cohort study in Rotterdam, the Netherlands that started in 1989. At baseline 4648 persons aged ≥55, free of CVD were classified into those with and those without radiographic or clinical OA. HRs adjusted for traditional cardiovascular risk factors for developing CVD (a composite of fatal and non-fatal coronary heart disease and stroke) were calculated.
  
  
  RESULTS
  During a median follow-up of 14.4 years, 1230 cardiovascular events occurred, of which 101 were in participants with clinical OA. Presence of radiographic OA at baseline was not related to future CVD (HR 0.99, 95% CI 0.86 to 1.15), neither was presence of clinical OA (HR 1.09, 95% CI 0.88 to 1.34). However, persons with increasing disability were more likely to suffer a cardiovascular event compared with non-disabled persons (HR 1.26, 95% CI 1.12 to 1.42); this was independent of the presence of OA.
  
  
  CONCLUSIONS
  In this large population-based study, participants with OA were not at increased risk of CVD. The close relation between disability and osteoarthritis may explain previous findings. Further studies are required in order to clarify whether OA patients need more intensive treatment of their cardiovascular risk factors.
authors.affiliation: Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: T A
authors.initials: TA
authors.lastname: Hoeven
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M J G
authors.initials: MJ
authors.lastname: Leening
authors.affiliation: Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: Bindels
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Castaño-Betancourt
authors.affiliation: Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J B
authors.initials: JB
authors.lastname: van Meurs
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: O H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Kavousi
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J C M
authors.initials: JC
authors.lastname: Witteman
authors.affiliation: Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: S M
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology*
keywords: cardiovascular disease; disability; population-based