title: Risk of vascular events in patients with polymyalgia rheumatica.
abstract: BACKGROUND
  Polymyalgia rheumatica is one of the most common inflammatory rheumatologic conditions in older adults. Other inflammatory rheumatologic disorders are associated with an excess risk of vascular disease. We investigated whether polymyalgia rheumatica is associated with an increased risk of vascular events.
  
  
  METHODS
  We used the General Practice Research Database to identify patients with a diagnosis of incident polymyalgia rheumatica between Jan. 1, 1987, and Dec. 31, 1999. Patients were matched by age, sex and practice with up to 5 patients without polymyalgia rheumatica. Patients were followed until their first vascular event (cardiovascular, cerebrovascular, peripheral vascular) or the end of available records (May 2011). All participants were free of vascular disease before the diagnosis of polymyalgia rheumatica (or matched date). We used Cox regression models to compare time to first vascular event in patients with and without polymyalgia rheumatica.
  
  
  RESULTS
  A total of 3249 patients with polymyalgia rheumatica and 12 735 patients without were included in the final sample. Over a median follow-up period of 7.8 (interquartile range 3.3-12.4) years, the rate of vascular events was higher among patients with polymyalgia rheumatica than among those without (36.1 v. 12.2 per 1000 person-years; adjusted hazard ratio 2.6, 95% confidence interval 2.4-2.9). The increased risk of a vascular event was similar for each vascular disease end point. The magnitude of risk was higher in early disease and in patients younger than 60 years at diagnosis.
  
  
  CONCLUSIONS
  Patients with polymyalgia rheumatica have an increased risk of vascular events. This risk is greatest in the youngest age groups. As with other forms of inflammatory arthritis, patients with polymyalgia rheumatica should have their vascular risk factors identified and actively managed to reduce this excess risk.
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK.
authors: Adam T
authors: AT
authors: Hancock
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK c.d.mallen@keele.ac.uk.
authors: Christian D
authors: CD
authors: Mallen
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK.
authors: Sara
authors: S
authors: Muller
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK.
authors: John
authors: J
authors: Belcher
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK.
authors: Edward
authors: E
authors: Roddy
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK.
authors: Toby
authors: T
authors: Helliwell
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK.
authors: Samantha L
authors: SL
authors: Hider
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016491:Peripheral Vascular Diseases / Q000209:etiology; D011111:Polymyalgia Rheumatica / Q000150:complications*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000209:etiology*