What can patients with rheumatoid do to reduce their risk of heart disease?
The Classic Risk Factors
The classic risk factors are very important in everyone, and equally so in those with rheumatoid arthritis. This means ideally:
not smoking – or reduce and stop if you do
not being overweight – and losing weight if necessary
having normal blood pressure – and treating it actively if it’s high
not having diabetes – and treating it well if one has it
having a good cholesterol profile – and treating it if necessary
Treat the Rheumatoid
Treating rheumatoid arthritis well is also associated with a lower risk of heart attacks. Having active inflammation seems to accelerate heart disease and stroke and controlling the autoimmune disease is essential for controlling the risk.
Exercise!
There are lots of pointers that exercise is important for cardiac health. There hasn’t been enough study in this area in rheumatoid arthritis, but exercise is likely to improve fatigue and pain and to improve cardiac health in many ways.
Aspirin? No clear evidence
There is conflicting evidence as to whether aspirin may be of any benefit. No proper clinical trials have been done. There have been studies looking at how often heart attacks occur in patients with rheumatoid arthritis who happen to be taking or not taking aspirin.
Two studies from the UK did not find that patients taking aspirin had a lower risk, but an Italian multi-centre study did find a significantly lower risk of heart attacks in those taking aspirin.
Rheumatoid drugs
See our separate piece about rheumatoid drugs. Non-steroidal anti-inflammatories (NSAIDs) are bad news for the heart, while drugs such as hydroxychloroquine, methotrexate and anti-TNF therapies are associated with reduction in heart disease, probably by controlling the inflammatory condition which is accelerating it.