The effects of age, seropositivity and disease duration on autonomic cardiovascular reflexes in patients with rheumatoid arthritis.

Previous studies have shown that autonomic cardiovascular reflexes (ACRs) are impaired in rheumatoid arthritis (RA) and in old age. To investigate the integrity of ACRs in patients with RA, with reference to age, duration of disease and rheumatoid factor (RF) positivity, we conducted a prospective open study of 62 RA outpatients (age 38-84) and 41 healthy controls (age 22-82) using five standard tests of ACR function. Patients of all ages with RA were found to have blunted ACRs when compared with younger controls, though this effect was subclinical. Older RA patients did not have significantly more ACR impairment than older controls. There was a tendency to greater impairment of ACRs in RA patients with a positive RF. The age-associated changes in ACRs in normal subjects are similar to those seen in RA patients of all ages. The effects of RA and age on ACRs do not appear to be additive.