New insights to the mechanisms underlying atherosclerosis in rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is an inflammatory circumstance, which has been associated with increased risk of cardiovascular disease (CVD). Although RA management has been promoted, mortality rate due to CVD remains remarkable. Approximately, 50% of premature death cases in RA are attributable to CVD. RA patients develop atherosclerosis in a greater amount than the general population. Moreover, atherosclerotic lesions develop rapidly in RA patients and might be more susceptible to rupture. The inflammatory condition of RA, such as cytokines, abnormally activated immune cells, play a role in the initiation, perpetuation and exacerbation of atherosclerosis. RA and CVD have genetic and environmental contributing risk factors in common, implying to potential coincidence of both disorders. Accelerated atherosclerosis in RA is attributed to inflammation, which carries its role out both through modulation of traditional risk factors and direct effect on the vessel wall. Hence, anti-inflammatory medications in RA like tumor necrosis factor blockers might have a beneficial effect on preventing cardiovascular development. Increasing age, smoking, hypertension, male gender, hypercholesterolemia and diabetes are enumerated as traditional CVD risk factors. Hopefully, further understanding of the cardiovascular risk factors by perceiving the disease conditions behind CVD, will improve management of cardiovascular risks in patients with RA.

Cardiometabolic comorbidities in RA and PsA: lessons learned and future directions

“…Individuals with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) have an increased risk of cardiometabolic comorbidities compared with the general population 1,2 . The strong association between RA and cardiovascular disease (CVD) has been well-studied and is likely related to the underlying state of chronic inflammation in RA and the accompanied increase in several pro-inflammatory cytokines that are also involved in the pathogenesis of atherosclerosis 3 .…”

Endothelium-derived contraction in a model of rheumatoid arthritis is mediated via angiotensin II type 1 receptors

“…Indeed vascular incident is around 4-times more common in people with RA meaning the condition is comparable to type 2 diabetes as an independent risk factor for the development of atherosclerosis and cardiovascular disease [3][4][5]. The causes of RA and atherosclerosis are not fully understood and likely to be multifactorial in nature but both diseases are recognized to have a strong inflammatory component with suggestion that inflammatory pathways may be common to both disorders [6][7][8]. Of these, the renin-angiotensin system, and angiotensin II (Ang II) in particular, has received recent attention [9].…”

Correlation between carotid intima-media thickness and serum TNF-alpha levels in female with rheumatoid arthritis of different ethnicities: A single-centre experience in Malaysia

“…5 Rheumatoid arthritis has been reported to be associated with increased risk of cardiovascular disease with approximately 50% of premature death in RA was due to cardiovascular disease. 6 The associations among endothelial dysfunction, atherosclerosis, and cardiac events are well established. Intima-media thickness of the common carotid artery can predict cardiovascular events.…”