Association of Cardiovascular Risk Factors with Carotid Intima Media Thickness in Patients with Rheumatoid Arthritis with Low Disease Activity Compared to Controls: A Cross-Sectional Study.
OBJECTIVE
Rheumatoid arthritis (RA) has been identified as an independent cardiovascular risk factor. The importance of risk factors such as hypertension and hyperlipidemia in the generation of atherosclerosis in RA patients is unclear. This study analyzed clinical parameters associated with carotid intima media thickness (cIMT) in patients with RA.


METHODS
Subjects with RA and healthy controls without RA, both without known cardiovascular disease, were included. Participants underwent a standard physical examination and laboratory measurements including a lipid profile. cIMT was measured semi-automatically by ultrasound.


RESULTS
In total 243 RA patients and 117 controls were included. The median RA disease duration was 7 years (IQR 2-14 years). The median DAS28 was 2.4 (IQR 1.6-3.2) and 114 (50.4%) of the RA patients were in remission. The presence of RA and cIMT were not associated (univariate analysis). Multivariable regression analysis showed that cIMT in RA patients was associated with age (B = 0.006, P<0.001) and systolic blood pressure (B = 0.003, P = 0.003). In controls, cIMT was associated with age (B = 0.006, P<0.001) and smoking (B = 0.097, P = 0.001).


CONCLUSIONS
cIMT values were similar between RA patients and controls. Hypertension was strongly associated with cIMT in RA patients. After adjustment, no association between cIMT and specific RA disease characteristics was found in this well treated RA cohort.
Department of Rheumatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Deborah F
DF
van Breukelen-van der Stoep
Department of Rheumatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Derkjen
D
van Zeben
Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Boudewijn
B
Klop
Department of Clinical Chemistry, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Gert-Jan M
GJ
van de Geijn
Department of Clinical Chemistry, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Hans J W
HJ
Janssen
Department of Rheumatology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Mieke J M W
MJ
Hazes
Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands; Statistics and Education, St. Franciscus Gasthuis, Rotterdam, The Netherlands.
Erwin
E
Birnie
Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Noelle
N
van der Meulen
Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Marijke A
MA
De Vries
Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Manuel
M
Castro Cabezas
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index
D008055:Lipids