title: Cardiovascular risk assessment and treatment in chronic inflammatory disorders in primary care.
abstract: To compare differences in cardiovascular (CV) risk factors assessment and management among patients with rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) with that of matched controls.
  
  
  
  A matched cohort study was conducted using primary care electronic health records for one London borough. All patients diagnosed with RA or IBD, and matched controls registered with local general practices on 12th of January 2014 were identified. The study compared assessment and treatment of CV risk factors (blood pressure, body mass index, cholesterol and smoking) in the year before, the year after, and 5 years after RA and IBD diagnosis.
  
  
  
  A total of 1121 patients with RA and 1875 patients with IBD were identified and matched with 4282 and, respectively, 7803 controls. Patients with RA were 25% (incidence rate ratio, 1.25, 95% CI 1.12 to 1.35) more likely to have a CV risk factor measured compared with matched controls. The difference declined to 8% (1.08, 1.04 to 1.14) over 5 years of follow-up. The corresponding figures for IBD were 26% (1.26, 1.16 to 1.38) and 10% (1.10, 1.05 to 1.15). Patients with RA showed higher antihypertensive prescription rates during 5 years of follow-up (OR, 1.37, 95% CI 1.14 to 1.65) and patients with IBD showed higher statin prescription rates in the year preceding diagnosis (2.30, 1.20 to 4.42). Incomplete CV risk assessment meant that QRISK scores could be calculated for less than a fifth (17%) and clinical recording of CV disease (CVD) risk scores among patients with RA and IBD was 11% and 6%, respectively.
  
  
  
  The assessment and treatment of vascular risk in patients with RA and IBD in primary care is suboptimal, particularly with reference to CVD risk score calculation.
authors.affiliation: Department of Primary Care and Public Health, King's College London, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Emanuel
authors.affiliation: Department of Primary Care and Public Health, King's College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Charlton
authors.affiliation: Department of Primary Care and Public Health, King's College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ashworth
authors.affiliation: Department of Primary Care and Public Health, King's College London, London, UK.|National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' National Health Service Foundation Trust, Kings' College London, London UK.
authors.forename: M C
authors.initials: MC
authors.lastname: Gulliford
authors.affiliation: Department of Primary Care and Public Health, King's College London, London, UK.|National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' National Health Service Foundation Trust, Kings' College London, London UK.
authors.forename: A
authors.initials: A
authors.lastname: Dregan
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D002908:Chronic Disease; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D057286:Electronic Health Records; D005260:Female; D019983:Guideline Adherence / Q000639:trends; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000628:therapy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011320:Primary Health Care / Q000639:trends*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013997:Time Factors; D014504:Urban Health / Q000639:trends
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol