Assessment of Cardiovascular Disease Risk and Therapeutic Patterns among Urban Black Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA) patients have nearly twice the risk of cardiovascular disease (CVD) compared to the general population. We aimed to assess, in a predominantly Black population, the prevalence of traditional and RA-specific CVD risk factors and therapeutic patterns. Utilizing ICD codes, we...

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Published in:	Medical sciences (Basel) Vol. 7; no. 2; p. 31
Main Authors:	McFarlane, Isabel M, Zhaz Leon, Su Yien, Bhamra, Manjeet S, Burza, Aaliya, Waite, Stephen Anthony, Rodriguez Alvarez, Milena, Koci, Kristaq, Taklalsingh, Nicholas, Kaplan, Ian, Pathiparampil, Joshy, Kabani, Naureen, Watler, Elsie, Sorrento, Cristina S, Frefer, Mosab, Vaitkus, Vytas, Green, Jason, Matthew, Keron, Arroyo-Mercado, Fray, Lyo, Helen, Soliman, Faisal, Sanchez, Randolph A, Reyes, Felix M, Ozeri, David J, Dronamraju, Veena, Trevisonno, Michael, Grant, Christon, Clerger, Guerrier, Amin, Khabbab, Freeman, Latoya, Dawkins, Makeda, Lopez, Diana Lenis, Smerling, Jonathan, Gondal, Irfan, Dellinger, Elaine, Paltoo, Karen, Bhat, Hina, Kolla, Srinivas
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 20-02-2019 MDPI
Subjects:	Biological products Body mass index Cardiovascular disease cardiovascular outcomes Diabetes Drug dosages erosive disease extra-articular manifestations Hypertension Inflammation Medical research Nonsteroidal anti-inflammatory drugs Population Rheumatoid arthritis rheumatoid arthritis specific risk factors Rheumatology Risk factors seropositive rheumatoid arthritis therapeutic patterns traditional risk factors Womens health traditional risk factors cardiovascular outcomes seropositive rheumatoid arthritis extra-articular manifestations erosive disease rheumatoid arthritis rheumatoid arthritis specific risk factors therapeutic patterns
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Summary:	Rheumatoid arthritis (RA) patients have nearly twice the risk of cardiovascular disease (CVD) compared to the general population. We aimed to assess, in a predominantly Black population, the prevalence of traditional and RA-specific CVD risk factors and therapeutic patterns. Utilizing ICD codes, we identified 503 RA patients ≥18 years old who were seen from 2010 to 2017. Of them, 88.5% were Black, 87.9% were women and 29.4% were smokers. CVD risk factors (obesity, diabetes, hypertension, dyslipidemia) were higher than in previously reported White RA cohorts. Eighty-seven percent of the patients had at least one traditional CVD risk factor, 37% had three or more traditional CVD risk factors and 58% had RA-specific risk factors (seropositive RA, >10 years of disease, joint erosions, elevated inflammatory markers, extra-articular disease, body mass index (BMI) < 20). CV outcomes (coronary artery disease/myocardial infarction, heart failure, atrial fibrillation and stroke) were comparable to published reports. Higher steroid use, which increases CVD risk, and lesser utilization of biologics (decrease CV risk) were also observed. Our Black RA cohort had higher rates of traditional CVD risk factors, in addition to chronic inflammation from aggressive RA, which places our patients at a higher risk for CVD outcomes, calling for revised risk stratification strategies and effective interventions to address comorbidities in this vulnerable population.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2076-3271 2076-3271
DOI:	10.3390/medsci7020031