Patients with inflammatory arthritis demonstrated a higher rate of cardiovascular disease compared with those with osteoarthritis and similar levels to patients with diabetes mellitus, according to study results.
Researchers investigated medical records of 175,061 patients of general practitioners in the Netherlands, with 1,518 diagnosed with inflammatory arthritis (IA), 11,959 with diabetes mellitus (DM), and 4,040 with osteoarthritis (OA). There were 158,439 controls. Some patients were diagnosed with more than one disease. Multilevel logistic regression analyses adjusted for age, gender hypercholesterolemia and hypertension.
Patients with IA (OR=2.1; 95% CI, 1.7-2.7), DM (OR=3.7; 95% CI, 3.5-4.0) and OA (OR=1.9; 95% CI, 1.6-2.2) displayed significantly higher cardiovascular disease (CVD) rates compared with controls before adjustment. Results became less severe when adjusted but remained associated with CVD for patients with IA (OR=1.5; 95% CI, 1.2-1.9) and DM (OR=1.3; 95% CI, 1.2-1.4). Adjustment created a reverse association between OA and CVD (OR=0.8; 95% CI, 0.7-1.0).
Myocardial infarction (MI), transient ischemic attack (TIA) and stroke/cerebrovascular accident (CVA) were measured as dependent variables after adjustment. OA did not differ with the subgroups when compared with the overall CVD results. Although IA was positively associated with MI (OR=1.3), TIA (OR=1.4) and CVA (OR=1.5); only IA and CVA showed a significant association. MI (OR=1.3) and CVA (OR=1.4) were significantly associated with DM.
Researchers said study limitations included the number of patients, which made diagnoses impossible to validate, and that patients were not measured in a structured or regular mode.
“This is the first study demonstrating an increased prevalence rate of CVD in inflammatory arthritis to levels broadly similar to diabetes mellitus in a representative primary care population,” the researchers concluded. “The lack of excess CVD in osteoarthritis further suggests that systemic inflammatory load appears critical to the CVD burden in inflammatory arthritis.”