title: Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis.
abstract: To examine for a possible relationship between osteoarthritis and cardiovascular disease.
  
  
  
  A systematic review and meta-analysis.
  
  
  
  Published and unpublished literature from: MEDLINE, EMBASE, CINAHL, the Cochrane Library, OpenGrey and clinical trial registers. Search to 22 November 2014. Cohort, case-control, randomised and non-randomised controlled trial papers reporting the prevalence of cardiovascular disease in osteoarthritis were included.
  
  
  
  Fifteen studies with 32,278,744 individuals were eligible. Pooled prevalence for overall cardiovascular disease pathology in people with osteoarthritis was 38.4% (95% confidence interval (CI): 37.2% to 39.6%). Individuals with osteoarthritis were almost three times as likely to have heart failure (relative risk (RR): 2.80; 95% CI: 2.25 to 3.49) or ischaemic heart disease (RR: 1.78; 95% CI: 1.18 to 2.69) compared with matched non-osteoarthritis cohorts. No significant difference was detected between the two groups for the risk of experiencing myocardial infarction or stroke. There was a three-fold decrease in the risk of experiencing a transient ischaemic attack in the osteoarthritis cohort compared with the non-osteoarthritis group.
  
  
  
  Prevalence of cardiovascular disease in patients with osteoarthritis is significant. There was an observed increased risk of incident heart failure and ischaemic heart disease in people with osteoarthritis compared with matched controls. However, the relationship between osteoarthritis and cardiovascular disease is not straightforward and there is a need to better understand the potential common pathways linking pathophysiological mechanisms.
authors.affiliation: Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hall
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK.
authors.forename: Mamas A
authors.initials: MA
authors.lastname: Mamas
authors.affiliation: Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, UK.
authors.forename: Phyo K
authors.initials: PK
authors.lastname: Myint
authors.affiliation: Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK toby.smith@uea.ac.uk.
authors.forename: Toby O
authors.initials: TO
authors.lastname: Smith
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D006801:Humans; D015994:Incidence; D016017:Odds Ratio; D010003:Osteoarthritis / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
keywords: Osteoarthritis; cardiovascular disease; cerebrovascular disease; hypertension; myocardial infarction