RA and Cardiovascular Disease

  

Cardiovascular Disease and Rheumatoid Arthritis

Research has shown that rheumatoid arthritis (RA) patients have a shorter life expectancy than the general population. This is mostly due to the increased prevalence of cardiovascular disease (CVD) in RA patients. Researchers have yet to determine the exact reason for this high occurrence rate, but we do know that there are several things that you can do to decrease either your risk or severity of CVD.

Suggestion 1: Reduce your cardiovascular risk factor profile

a.) Compute your personal risk factor score:
You can compute your cardiovascular disease risk score at http://www.nhlbi.nih.gov/about/framingham/riskabs.htm.
You will need information such as blood pressure and cholesterol measures from
your doctor to compute this score.

b.) Take an active role

If you…   You can
Smoke
Quit Smoking
Have High Blood Pressure
Take antihypertensive meds*, diet,exercise
Have High Cholesterol
Take statin meds**, diet, exercise
Live a Sedentary Lifestyle
Exercise
Have Obesity
Diet, exercise
Have Diabetes
Reduce blood sugar, diet, exercise
Have a Family History of Heart Disease
Keep cholesterol, blood pressure andinflammation low

* Antihypertensive medications lower high blood pressure. Common antihypertensives
are Zetril, Vasotec, Diovan, Coreg, Atenolol, Hztc, and Norvasc.

** Statin medications are cholesterol-lowering agents such as: Lipitor, Zocor,
Zetia, and Pravachol.

c.) Modify your diet into a heart healthy diet by eating foods that
are:

1. Low in cholesterol

– Get recommendations for calorie and cholesterol intake based on your
height, weight, age, and level of activity. http://www.nhlbisupport.com/cgi-bin/chd1/step1intro.cgi

2. Low in fat

-Get recommendations for a low fat diet

http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/lcal_fat.htm

3. High in Omega-3s

-Found in: fish, flax, krill, meat (from grass-fed animals as opposed
to grain-fed animals), grape seed oil, and omega-3 supplements

d.) Have blood tests for CRP and cholesterol profile

    1. A CRP (C-reactive protein) test is a simple blood
      test that is used to detect levels of acute inflammation in the body.
      Rheumatoid arthritis patients have much higher levels of CRP than the
      general population. Therefore, your rheumatologist will need to interpret
      the test results accordingly.
    2. A cholesterol profile is another type of blood test
      that measures the level of several fats in your blood that tend to increase
      your risk for cardiovascular disease. The test determines your total cholesterol,
      HDL cholesterol, LDL cholesterol, triglycerides and your cholesterol ratio.

Suggestion 2: Reduce Inflammation

a.) Work with your rheumatologist to find drug therapies that
work towards reducing inflammation

    1. TNF-alpha blockers-Enbrel, Humira, Remicade
    2. Biologics- Orencia, Rituxan
    3. Methotrexate

b.) Exercise

c.) Talk to your primary care physician about taking statin medications

Suggestion 3: Try to Avoid Medications that Increase Your Risk

a.) Steroids (like prednisone)
– increase your cholesterol and blood sugar levels
b.) Cox-2 inhibitors (like Celebrex
– increase your risk of heart attack

Suggestion 4: Reduce Clotting

a.) Men >50 & Women >60
Can take one baby aspirin a day to prevent heart attacks