Cardiovascular disease in rheumatoid arthritis: medications and risk factors in China.
This study aims to assess the risk factors of cardiovascular disease (CVD) and to determine the association of traditional and biologic disease-modifying anti-rheumatic drugs (DMARDs) with risk for CVD in Chinese rheumatoid arthritis (RA) patients. A cross-sectional cohort of 2013 RA patients from 21 hospitals around China was established. Medical history of CVD was documented. The patients' social background, clinical manifestations, comorbidities, and medications were also collected. Of the 2013 patients, 256 had CVD with an incidence of 12.7%. Compared with non-CVD controls, RA patients with CVD had a significantly advanced age, long-standing median disease duration, more often male and more deformity joints. Patients with CVD also had higher rates of smoking, rheumatoid nodules, interstitial lung disease, and anemia. The prevalence of comorbidities, including hypothyroidism, diabetes mellitus (DM), hypertension, and hyperlipidemia, was also significant higher in the CVD group. In contrast, patients treated with methotrexate, hydroxychloroquine (HCQ), and TNF blockers had lower incidence of CVD. The multivariate analysis showed that the use of HCQ was a protective factor of CVD, while hypertension, hyperlipidemia, and interstitial lung disease were independent risk factors of CVD. Our study shows that the independent risk factors of CVD include hypertension, hyperlipidemia, and interstitial lung disease. HCQ reduces the risk of CVD in patients with RA.
Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China.
Chun
C
Li
Department of Rheumatology and Immunology, Peking University Shougang Hospital, 9 Jinyuanzhuang Street, Beijing, 100144, China.
X R
XR
Wang
Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China.
H J
HJ
Ji
Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China.
X Y
XY
Zhang
Department of Rheumatology and Immunology, The Second Affiliated Hospital Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China.
X F
XF
Li
Department of Rheumatology and Immunology, The Second Affiliated Hospital Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China.
L Z
LZ
Wang
Department of Rheumatology and Immunology, The Second Affiliated Hospital Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, China.
C H
CH
Wang
Department of Rheumatology and Immunology, The First Affiliated Hospital, Baotou Medical College, 41 Linyin Road, Baotou, 014010, China.
Y F
YF
Wang
Department of Rheumatology and Immunology, The First Affiliated Hospital, Baotou Medical College, 41 Linyin Road, Baotou, 014010, China.
Rong
R
Yang
Department of Rheumatology and Immunology, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China.
G C
GC
Wang
Department of Rheumatology and Immunology, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China.
Xin
X
Lu
Department of Rheumatology and Immunology, Xijing Hospital, 15 Changle Road, Xian, 710032, China.
Ping
P
Zhu
Department of Rheumatology and Immunology, Xijing Hospital, 15 Changle Road, Xian, 710032, China.
L N
LN
Chen
Department of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China.
H T
HT
Jin
Department of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China.
J T
JT
Liu
Department of Rheumatology and Immunology, Peking University Third Hospital, 49 North Garden Rd, Beijing, 100191, China.
X Y
XY
Liu
Department of Rheumatology and Immunology, Peking University Third Hospital, 49 North Garden Rd, Beijing, 100191, China.
Lin
L
Sun
Department of Rheumatology and Immunology, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050000, China.
H Y
HY
Chen
Department of Rheumatology and Immunology, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050000, China.
Ping
P
Wei
Department of Rheumatology and Immunology, The Third Hospital of Hebei Medical University, 139 Ziqiang Rd, Shijiazhuang, 050000, China.
J X
JX
Wang
Department of Rheumatology and Immunology, Kailuan Hospital of North China Coal Hospital, 57 West Xinhua Rd, Tangshan, 063000, China.
L F
LF
Cui
Department of Rheumatology and Immunology, Kailuan Hospital of North China Coal Hospital, 57 West Xinhua Rd, Tangshan, 063000, China.
Rong
R
Shu
Department of Rheumatology and Immunology, Kailuan Hospital of North China Coal Hospital, 57 West Xinhua Rd, Tangshan, 063000, China.
B L
BL
Liu
Department of Rheumatology and Immunology, Peking University First Hospital, 8 Xishiku Road, Beijing, 100034, China.
Z L
ZL
Zhang
Department of Rheumatology and Immunology, Peking University First Hospital, 8 Xishiku Road, Beijing, 100034, China.
G T
GT
Li
Department of Rheumatology and Immunology, Peace Hospital, 398 West Zhongshan Rd, Shijiazhuang, 050082, China.
Z B
ZB
Li
Department of Rheumatology and Immunology, Peace Hospital, 398 West Zhongshan Rd, Shijiazhuang, 050082, China.
Jing
J
Yang
Department of Rheumatology and Immunology, Hebei Handan Central Hospital, 311 Heping Rd, Handan, 056001, China.
J F
JF
Li
Department of Rheumatology and Immunology, Hebei Handan Central Hospital, 311 Heping Rd, Handan, 056001, China.
Bin
B
Jia
Department of Rheumatology and Immunology, Hebei People's Hospital, 348 West Heping Rd, Shijiazhuang, 050051, China.
F X
FX
Zhang
Department of Rheumatology and Immunology, Hebei People's Hospital, 348 West Heping Rd, Shijiazhuang, 050051, China.
J M
JM
Tao
Department of Rheumatology and Immunology, Peking University Shougang Hospital, 9 Jinyuanzhuang Street, Beijing, 100144, China.
S L
SL
Han
Department of Rheumatology and Immunology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Rd, Nanning, 530021, China.
J Y
JY
Lin
Department of Rheumatology and Immunology, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Rd, Nanning, 530021, China.
M Q
MQ
Wei
Department of Rheumatology and Immunology, Beijing Shunyi Hospital of China Medical University, 3 South Guangming Rd, Beijing, 101300, China.
X M
XM
Liu
Department of Rheumatology and Immunology, Beijing Shunyi Hospital of China Medical University, 3 South Guangming Rd, Beijing, 101300, China.
Dan
D
Ke
Department of Rheumatology and Immunology, Tongji Medical College Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China.
S X
SX
Hu
Department of Rheumatology and Immunology, Tongji Medical College Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China.
Cong
C
Ye
Department of Rheumatology and Immunology, First Affiliated Hospital of Sun Yat-sen University, 58 Second Zhongshan Rd, Guangzhou, 510080, China.
X Y
XY
Yang
Department of Rheumatology and Immunology, First Affiliated Hospital of Sun Yat-sen University, 58 Second Zhongshan Rd, Guangzhou, 510080, China.
Hao
H
Li
Department of Rheumatology and Immunology, Beijing Hospital, 1 Dahua Rd, Beijing, 100730, China.
C B
CB
Huang
Department of Rheumatology and Immunology, Beijing Hospital, 1 Dahua Rd, Beijing, 100730, China.
Ming
M
Gao
Department of Rheumatology and Immunology, Beijing Hospital, 1 Dahua Rd, Beijing, 100730, China.
Bei
B
Lai
Department of Rheumatology and Immunology, Qilu Hospital of Shandong University, 107 Jinan Culture Road, Jinan, 250012, China.
X F
XF
Li
Department of Rheumatology and Immunology, Qilu Hospital of Shandong University, 107 Jinan Culture Road, Jinan, 250012, China.
L J
LJ
Song
Department of Rheumatology and Immunology, Second Hospital of Lanzhou University, 82 Cuiyingmen Rd, Lanzhou, 730030, China.
Yi
Y
Wang
Department of Rheumatology and Immunology, Second Hospital of Lanzhou University, 82 Cuiyingmen Rd, Lanzhou, 730030, China.
X Y
XY
Wang
Department of Cardiology, Fuwai Hospital, North Lishi Road, Beijing, 100037, China.
Y D
YD
Tang
Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China.
Yin
Y
Su
Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China. murong@pkuph.edu.cn.
Rong
R
Mu
Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xizhimen Street, Beijing, 100044, China. li99@bjmu.edu.cn.
Z G
ZG
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
D018501:Antirheumatic Agents
Cardiovascular disease; Rheumatoid arthritis; Risk factor