RESEARCH - RA and CV disease: the role of systemic inflammation and evolving strategies of prevention

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Curr Opin Rheumatol. 2005 May;17(3):234-41.

Rheumatoid arthritis and cardiovascular disease: the role of systemic

inflammation and evolving strategies of prevention.

Snow MH, Mikuls TR.

Department of Medicine, Section of Rheumatology and Immunology, University

of Nebraska Medical Center, and Omaha Veterans Affairs Medical Center,

Omaha, Nebraska, USA.

PURPOSE OF REVIEW: The incidence and mortality of cardiovascular disease are

increased in the context of rheumatoid arthritis. The purpose of this review

is to examine our evolving understanding of the pathogenesis of

cardiovascular disease in rheumatoid arthritis and to underscore the

importance of tailored prevention of cardiovascular disease in this select

population. RECENT FINDINGS: Recent reports have highlighted the shared

pathobiology of cardiovascular disease and rheumatoid arthritis, both of

which represent inflammatory disorders. Several reports have also provided

much-needed insight into the deleterious impact that select therapies

(including cyclo-oxygenase-2-specific inhibitors) may have in terms of the

risk of cardiovascular disease in rheumatoid arthritis. Although further

study is warranted, preliminary investigations also suggest that aggressive

anti-inflammatory therapy, including the adjunctive use of statins, may play

important cardioprotective roles in rheumatoid arthritis.

SUMMARY: The pathogenesis of cardiovascular disease in rheumatoid arthritis

is complex and involves several intermediate factors, including

dyslipidemia, elevations in serum homocysteine, impaired insulin

sensitivity, and endothelial dysfunction. Given the burden of cardiovascular

disease in this population, it is important that health care providers

caring for rheumatoid arthritis patients adopt a treatment course that is

both comprehensive and individualized to address specific risk factors for

cardiovascular disease.

PMID: 15838230

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5838230 & dopt=Abstract

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