Cardiovascular risk management in rheumatoid and psoriatic arthritis: online survey results from a national cohort study

Abstract

Background Chronic inflammatory arthritis is associated with increased cardiovascular (CV) morbidity and mortality. Pharmacological management and healthy lifestyle modification is recommended to manage these risks, but it is not known how often these are utilised and whether there is any difference in their use between patients with different types of arthritis. The aim of this study was to determine and compare the proportion of participants with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) receiving pharmacological or lifestyle management strategies for CV risk factors. The secondary objective was to identify factors associated with use of management strategies. Methods A survey was sent to online participants in the Australian Rheumatology Association Database, a voluntary national registry for inflammatory arthritis. Participants were asked whether they took medications for hypertension, hyperlipidaemia and diabetes, and to report their height, weight, level of physical activity, and dietary changes made. The use of management strategies was compared between participants with RA and PsA. Logistic regression analyses were performed to identify factors associated with physical activity and dietary changes. Results There were 858 respondents with RA and 161 with PsA (response rate 64.5%). Pharmacological treatment was reported by 93% of participants with hypertension and 70% with hyperlipidaemia. All participants with diabetes reported being managed with dietary modification, pharmacological treatment, or a combination of both. Adequate physical activity was reported by 50.8%. Only 27% of overweight or obese participants reported making any dietary change for their health in the past year. There was no difference between RA and PsA in reported utilisation of management strategies. Hyperlipidaemia and being overweight were associated with making dietary change. Obesity and arthritis disease activity were negatively associated with physical activity. Conclusions Most participants with RA and PsA reported using pharmacological treatment for CV risk factors. Relatively few reported using lifestyle modifications. Targeted lifestyle interventions should be implemented for RA and PsA patients. Electronic supplementary material The online version of this article (10.1186/s41927-018-0032-9) contains supplementary material, which is available to authorized users.

The Impact of Comorbidity on Patient-Reported Outcomes in Psoriatic Arthritis: A Systematic Literature Review

“…Anxiety and depression were examined in two small cross-sectional studies using the Hospital Anxiety and Depression Scale (HADS) questionnaire [85,87]. Both studies found 58 Rhee/2012_2 [73] No data regarding the impact of comorbidity on PROs 59 Rosen/2012 [75] No data regarding the impact of comorbidity on PROs 60 Salaff/2009 [76] No data regarding the impact of comorbidity on PROs 61 Sinnathurai/2018 [77] No data regarding the impact of comorbidity on PROs 62 Sinnathurai/2018 [78] No numerical data provided 63 Szentpetery/2016 [79] No data regarding the impact of comorbidity on PROs 64 Tillet/2013 [80] No data regarding the impact of comorbidity on PROs…”

“…The second study was a prospective cohort of 3571 PsA patients [91]. The results showed a weak correlation between smoking (past and current) and HAQ, Fatigue Severity Scale (FSS), BASFI, pain, Functional Assessment of Chronic Illness Therapy (FACIT), BASDAI, ASQoL and SF-36 (physical and mental component) (r 2 \ 0.2, p \ 0.050) [77]. This study also evaluated current alcohol consumption and found that it was also weakly correlated with HAQ, FSS, BASFI, pain, FACIT, BASDAI, ASQoL, EQ-5D, Dermatology Quality of Life Index (DLQI), and SF-36 (physical and mental component) (r 2 \ 0.2, p \ 0.050) [91].…”

Lifestyle factors in patients with rheumatoid arthritis—a cross-sectional study on two Scandinavian cohorts

“…International guidelines from the European Alliance of Associations for Rheumatology (EULAR) endorse a structured cardiovascular risk management for patients with RA and emphasise that all lifestyle recommendations for patients with RA should highlight the benefits of smoking cessation, regular physical activity and a healthy diet [3]. While evidence and recommendations support a healthy lifestyle for patients with RA to improve the effects of treatment and to lower CVD risks, most patients with RA prefer pharmacological treatment to lifestyle changes [17]. Habits are hard to change and the need to change multiple habits might seem overwhelming.…”

Physical activity and barriers and facilitators in patients with rheumatoid arthritis or spondyloarthritis: a cross-sectional study of 150 patients

“…Patients with in ammatory arthritis (IA), such as axial spondyloarthritis (axSpA), rheumatoid arthritis (RA) or psoriatic arthritis (PsA) are more prone to physical inactivity than the general population [6,7]. Patients with IA derive speci c bene ts from regular physical activity [8][9][10].…”