Rheumatoid Arthritis and Heart Health

I would like to draw awareness to the cardiovascular risks that people with rheumatoid arthritis (RA) can experience. These can range from increased risk of heart attacks and strokes to inflammation of the lining around the heart and lungs.¹

Increased risk of heart disease

Rheumatoid arthritis doesn’t just cause inflammation locally in the joints and musculoskeletal tissues. Research studies also show elevated systemic inflammation that is widespread in the entire body and affects the blood vessels.²

In fact, many studies have shown a 48 to 50 percent higher risk of cardiovascular disease linked to rheumatoid arthritis. Higher levels of inflammation in the bloodstream can lead to faster development of atherosclerosis, which is abnormal plaque build-up on injured blood vessel walls. Atherosclerosis eventually leads to heart attacks and strokes.^2,3

Patients with RA can also have pericarditis (inflammation of the heart lining) or pleural effusions (fluid build-up around the lungs).¹

Typically, cardiovascular risks are higher when RA is uncontrolled and has higher disease activity level. Disease activity level can be reflected in the amount of joint pain, swelling, and stiffness a patient is experiencing, as well as certain lab markers of inflammation. Lowering the disease activity level of RA and reducing the frequency of flares can be good for heart health.^4,5

Medication side effects

People living with RA have greater exposure to drugs with side effects, such as prednisone or ibuprofen. Taking frequent courses of prednisone over long periods of time can cause complications like weight gain, diabetes, and increased coronary artery disease.²

Over-the-counter medicines such as Advil and Aleve are safe for the average person. But when they are overused, they can also cause damage to organs such as the heart or kidneys.²

Lowering traditional risk factors

Traditional risk factors for cardiovascular disease should be lowered as much as possible. This could include steps such as:⁶

• Quitting smoking
• Losing weight
• Controlling high blood pressure and/or high cholesterol
• Managing diabetes

The anti-inflammatory diet for autoimmune diseases is very similar to the Mediterranean diet for heart health. This includes increasing fruits and vegetables while reducing red meats, sugars, and processed foods. Adding nuts and fish containing omega-3 fatty acids is also helpful. Antioxidant foods and beverages such as berries and green tea are recommended for both RA and heart health.^7,8

Reducing RA disease activity

Controlling the disease activity level of RA will not just help with reducing pain and improving the function of your joints. It will also protect your heart and blood vessels against long-term damage from inflammation.⁷

Treatments such as methotrexate, hydroxychloroquine, and certain biologics have been found to have direct beneficial effects in reducing inflammation in blood vessel walls. This guards against damage and plaque buildup that lead to heart attacks and strokes.^9,10

People living with RA often find it difficult to stay physically active and exercise due to severe joint pain. A sedentary lifestyle and lack of physical activity can be another risk factor for developing heart disease. As RA is treated to remission, exercise becomes more realistic and can further lead to better heart health.⁷