{"id":20,"date":"2013-11-13T11:13:26","date_gmt":"2013-11-13T11:13:26","guid":{"rendered":"http:\/\/promotions.bmj.com\/ardsummaries\/?p=20"},"modified":"2013-11-13T11:13:26","modified_gmt":"2013-11-13T11:13:26","slug":"how-do-you-measure-heart-disease-risk-in-people-with-rheumatoid-arthritis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2013\/11\/13\/how-do-you-measure-heart-disease-risk-in-people-with-rheumatoid-arthritis\/","title":{"rendered":"How do you measure heart-disease risk in people with rheumatoid arthritis?"},"content":{"rendered":"

INTRODUCTION<\/strong><\/p>\n

A test called carotid ultrasound may be the best way to tell whether individuals with rheumatoid arthritis are at\u00a0high risk of heart disease, according to a new study.<\/p>\n

WHAT DO WE KNOW ALREADY?<\/strong><\/p>\n

As a general rule, we know that people with rheumatoid arthritis have a higher risk of heart disease compared\u00a0with the general population. Doctors aren\u2019t sure why this is, but they think that the inflammation (swelling)\u00a0that affects the joints might affect other parts of the body, such as the arteries. It is thought that this inflammation\u00a0might increase the chance of hardening of the arteries, which may lead to heart and circulation problems.<\/p>\n

<\/p>\n

So it\u2019s important that people with rheumatoid arthritis know whether they are at high risk of heart disease.\u00a0If people know they are more likely than usual to have heart problems, there are things they can do about it,\u00a0such as stopping smoking, changing their diet, taking more exercise, and losing weight if they are overweight.<\/p>\n

But the usual ways of checking heart-disease risk aren\u2019t very useful for many people with rheumatoid arthritis.\u00a0For example, a method called SCORE (Systematic COronary Risk Evaluation) can work out people\u2019s risk\u00a0of heart problems based on so-called \u2018risk factors\u2019. These include things like whether they smoke, their age,\u00a0their sex (men are more likely to have heart problems), their blood pressure, and their cholesterol level. But\u00a0tools like this don\u2019t take into account the extra heart-disease risk in people with rheumatoid arthritis. So they\u00a0are likely to miss people with rheumatoid arthritis who are at risk.\u00a0The new study looked at two ways of checking heart-disease risk in people with rheumatoid arthritis, carotid\u00a0ultrasound, and the Coronary Artery Calcification Score \u2013 CACS for short. Previous studies have shown that\u00a0both of these tests are better than tools like SCORE at showing heart-disease risk in people with rheumatoid
\narthritis.<\/p>\n

Now the researchers wanted to find out which test was the most reliable. They examined 95 people with\u00a0rheumatoid arthritis who had never had any heart problems, and whose average age was 59. The people were\u00a0given both tests, and the results were compared to see which test was the best at detecting who was at high risk
\nof heart disease.\u00a0The tests work in slightly different ways. With CACS, your doctor adds up a score based on how much\u00a0calcium you have in six major arteries. With carotid ultrasound, your doctor looks for two things: thickening\u00a0of the artery walls and the build up of substances called plaques in the arteries, which can cause the blood\u00a0vessels to become too narrow. Both these tests involve a doctor using a scanner. They don\u2019t hurt, there are no\u00a0needles, and the doctor doesn\u2019t need to take your blood.<\/p>\n

WHAT DOES THE NEW STUDY SAY?<\/strong><\/p>\n

The study found that carotid ultrasound was better at detecting which people with rheumatoid arthritis were\u00a0more likely to get heart disease. When compared with the SCORE system, testing with CACS found an extra\u00a012 people who were at high risk, who had been missed by the SCORE test. But testing with carotid ultrasound
\nfound an extra 51 people at high risk who had been missed when tested with SCORE.<\/p>\n

HOW RELIABLE ARE THE FINDINGS?<\/strong><\/p>\n

The main reason to be cautious about this study is that it\u2019s quite small. It\u2019s also important to remember that\u00a0tests like the ones in this study can\u2019t say who will definitely develop heart problems. They can only tell us who\u00a0is more likely to have problems, based on doctors\u2019 past experience.<\/p>\n

WHAT DOES THIS MEAN FOR ME?<\/strong><\/p>\n

If you have rheumatoid arthritis it\u2019s important to know that you may have a greater chance than most people\u00a0of getting heart disease. Having a test like carotid ultrasound can help show you how big that risk might be. If\u00a0you are at higher risk you can make changes to your lifestyle, and get treatment to lower your blood pressure\u00a0and the amount of fats in your blood.But even without a test, it may be more important for you than for most people to look after your heart. If
\nyou want to know more about tests like carotid ultrasound, or about avoiding heart problems, you can talk to\u00a0your doctor or rheumatologist.<\/p>\n

Disclaimer<\/strong>: This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. \u00a0It should not be relied on in any way whatsoever<\/span>, (which also means the Summary is not medical advice), and is simply supplied to aid a lay understanding of general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be accurate as errors can occur and also may be out of date as medical science is constantly changing. \u00a0It is very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care. Do not use this Summary as medical advice even if the Summary is supplied to the reader by a medical professional.<\/strong>
\nPlease view our full Website Terms and Conditions<\/a>.<\/p>\n

Date summary prepared:\u00a0November 2013<\/p>\n

Summary based on research article published on:\u00a013 July 2013<\/p>\n

From:\u00a0Corrales, A. et al.<\/em> Cardiovascular risk stratification in rheumatic diseases: carotid ultrasound is more sensitive than Coronary Artery Calcification Score to detect subclinical atherosclerosis in patients with rheumatoid arthritis.\u00a0Ann Rheum Dis<\/em> 2013;72:1764-1770 doi:10.1136\/annrheumdis-2013-203688<\/a><\/p>\n

Copyright \u00a9 2015 BMJ Publishing Group Ltd & European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our Rights and Licensing<\/a> Team.<\/p>\n","protected":false},"excerpt":{"rendered":"

INTRODUCTION A test called carotid ultrasound may be the best way to tell whether individuals with rheumatoid arthritis are at\u00a0high risk of heart disease, according to a new study. WHAT DO WE KNOW ALREADY? As a general rule, we know that people with rheumatoid arthritis have a higher risk of heart disease compared\u00a0with the general […]<\/p>\n

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