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Cardiovascular Disease and Risk Factors in Patients with Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis

CHENGLONG HAN, DON W. ROBINSON Jr, MONICA V. HACKETT, L. CLARK PARAMORE, KATHY H. FRAEMAN, and MOHAN V. BALA

ABSTRACT.

Objective. To compare the prevalence of cardiovascular diseases and their risk factors between patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) and control subjects.

Methods. Data for patients continuously enrolled in an integrated outcomes database between January 1, 2001, and December 31, 2002, with International Classification of Diseases, 9th Revision codes of 714.x (RA), 696.0 (PsA), or 720.0 (AS) were evaluated in this cross-sectional comparative study. Control groups were established for each patient group (1:4 ratio) by matching on the basis of age, sex, geographic region, and length of time in plan. Age- and sex-adjusted prevalence of cardiovascular comorbidities and risk factors were calculated; the prevalence ratio of the comorbidities and risk factors for the patient groups compared with the control population were estimated. Use of selected cardiovascular medications was also compared between patient and control groups.

Results. The RA, PsA, and AS cohorts comprised 28,208, 3066, and 1843 patients, respectively. The prevalence ratio of ischemic heart disease (1.5, 1.3, 1.2), atherosclerosis (1.9, 1.4, 1.5), peripheral vascular disease (2.4, 1.6, 1.6), congestive heart failure (2.0, 1.5, 1.8), cerebrovascular disease (1.6, 1.3, 1.7), type II diabetes (1.4, 1.5, 1.2), hyperlipidemia (1.2, 1.2, 1.2), and hypertension (1.3, 1.3, 1.3) were higher in patients than controls. For RA, PsA, and AS, use of angiotensin-converting enzyme inhibitors, calcium channel blockers, diuretics, nitrates/vasodilators, anticoagulants, and antihyperlipidemia agents was significantly higher in patients than controls.

Conclusion. Cardiovascular diseases and their risk factors were more common in patients with RA, PsA, and AS than in matched controls. (First Release Sept 15 2006; J Rheumatol 2006;33:2167–72)

Key Indexing Terms:

RHEUMATOID ARTHRITIS
PSORIATIC ARTHRITIS

ANKYLOSING SPONDYLITIS
CARDIOVASCULAR DISEASE


From Centocor, Inc., Malvern, Pennsylvania; and Medtap Institute at United BioSource Corp., Bethesda, Maryland, USA.

Supported by Centocor, Inc.

C. Han, PhD; D.W. Robinson, MSPH; M.V. Hackett, MHS; M.V. Bala, PhD, Centocor, Inc.; L.C. Paramore, MSPM; K.H. Fraeman, SM, Medtap Institute at UBC.

Address reprint requests to Dr. C. Han, Centocor, Inc., Malvern, PA 19355, USA. E-mail: chan3@cntus.jnj.com

Accepted for publication May 1, 2006.




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