INTRODUCTION
Regular exercise can help keep blood vessels healthy in people with rheumatoid arthritis, as well as reducing their numbers of swollen joints.
WHAT DO WE KNOW ALREADY?
People with rheumatoid arthritis (RA) have a higher-than-usual risk of getting heart disease. We’re not quite sure why this is. It may be because the inflammation (swelling) that affects the joints in RA may also affect the body’s vascular system (the veins and arteries). So people with RA need to keep an eye on other factors that can make heart disease more likely, such as high blood pressure and cholesterol.
One thing that can help keep the heart and blood vessels healthy and reduce the chance of heart disease is taking regular exercise. But some people with RA worry that exercising might be painful and cause damage to the joints. And some people’s symptoms make it hard for them to do some kinds of exercise. Most research into reducing the chances of heart disease in people with RA has looked at how medicines can help. So it’s been difficult to know how to advise people with RA about whether exercise is helpful for them.
In this new study, researchers wanted to find out more about how taking regular exercise might affect people with RA.
The main thing they wanted to know was whether exercise could improve how well the blood vessels work in people with RA. But they also looked at whether exercise could help with the symptoms of RA itself. To do this, they divided 40 people with RA into matched pairs. This means that they made the pairs of people as similar as possible, according to things like their sex, age, weight, and disease activity.
One person in each pair then did a six-month exercise programme. The programme, which was tailored according to what each person was able to do, included both aerobic and resistance exercises (exercises with weights). The other group was given information on the benefits of exercise, but the people didn’t do a structured
programme.
After six months the researchers looked at several measures of health and RA symptoms. They checked how well people’s blood vessels and lungs worked, and their RA disease activity score (their DAS28, which includes counting how many swollen joints people have). They also looked at how much people had in their bodies of a
substance called CRP (C-reactive protein). High CRP means there is more inflammation.
WHAT DOES THE NEW STUDY SAY?
After six months, people in the exercise group had improvements in several measurements, compared with the people who didn’t do the exercise programme. The people who exercised had:
- Blood vessels that worked more efficiently.
- Better lung function, measured by how much oxygen they could process while exercising.
- Lower disease activity scores, meaning they may have fewer swollen, painful joints.
- Lower levels of CRP.
HOW RELIABLE ARE THE FINDINGS?
Matching pairs of people in the way that this study did is a useful way of testing how different treatments might work on similar people. So this study had sound methods. But it was small, so we have to be a little cautious about its results. Larger studies with more people would probably tell us more than this one can.
WHAT DOES THIS MEAN FOR ME?
If you have rheumatoid arthritis you may find it hard to do some kinds of exercise. But this study suggests that there are many benefits to exercising–not least that it can improve your vascular health (how well your blood vessels work). And healthier blood vessels means a lower chance of heart disease. Your rheumatologist or physiotherapist will be able to suggest types of exercise that should be designed to suit individual needs and physical abilities.
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Date summary prepared: March 2014
Summary based on research article published on: 31 July 2013
From: Metsios. G, S. et al. Individualised exercise improves endothelial function in patients with rheumatoid arthritis. Ann Rheum Dis 2014;73:748-751 doi:10.1136/annrheumdis-2013-203291
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