There’s new evidence that people with arthritis and other diseases caused by inflammation may be at an increased risk for cardiovascular disease.

This study specifically looked at patients with rheumatoid arthritis, although it’s possible that patients with other inflammatory conditions are also at increased risk.

Rheumatoid arthritis, or RA, is a long standing condition caused by inflammation which leads to painful, swollen, and deformed joints especially in the hands and feet.

Josephine Celentano has had RA for 14 years. “As you get older you never know what is going to happen, and yes I am concerned a little for the future,” says

But that inflammation may be doing damage to the arteries as well, putting RA patients at risk for heart attacks and strokes.

The latest research in the Annals of Internal Medicine shows that patients with rheumatoid arthritis have a high risk for atherosclerosis--artery blockages--that are present before any symptoms appear.

This is in spite of the fact that compared to those without RA, the RA patients have fewer traditional risk factors for heart disease –like smoking and diabetes--showing RA is an important factor itself!

Dr. Mark Horowitz, rheumatologist at Mt. Sinai Medical Center, says, “People with rheumatoid arthritis should be though of as being at high risk for heart disease, that is the most important part of the study.”

The researchers found blockages in the neck arteries of 44 percent –almost half--of the RA patients studied, compared to only 15 percent of patients without RA.
None of these patients had any symptoms.

Now while use of a group of powerful RA drugs called TNF-alpha inhibitors, like remicade, was associated with the increased atherosclerosis risk, the authors say there’s a good chance that just shows the most severe patients, who of course need these powerful drugs, are the ones to have the most severe inflammation and so have the most severe atherosclerosis.


Many believe patients with RA need to live a life of low cardiovascular risks—they need to exercise regularly, avoid cigarettes eat a low cholesterol diet, and have their blood pressure monitored on a frequent basis.

Dr. Jess Weinberger, a neurologist at Mt. Sinai Medical Center, says, “We have known for a long time that Creative protein which is one of the inflammatory markers that goes up in people with RA and other inflammatory disease is a major risk factor for heart attack and strokes. We also know that the medications that lower cholesterol reduce that C-reactive protein so there is inflammatory action going on in the plaque, so it may be that patients with RA would benefit from these statin medications to lower the amount of C-reactive protein but that would remain to be seen as well from other studies.”

And, getting the rheumatoid arthritis under control is perhaps just as important.

“If you can put the disease at remission or dramatically suppress the levels of inflammation than one can potentially say they are at lower risk but it is not clear if you can do that.”

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