Silvia Rollefstad1, Eirik Ikdahl1, Grunde Wibetoe1, Joe Sexton1, Cynthia S Crowson2,3, Piet van Riel4, George D Kitas5, Ian Graham6, Solbritt Rantapää Dahlqvist7, George Karpouzas8, Elena Myasoedova3, Miguel A Gonzalez-Gay9, Petros P Sfikakis10, Maria G Tektonidou10, Argyro Lazarini11, Dimitrios Vassilopoulos11, Bindee Kuriya12, Carol A Hitchon13, Maria Simona Stoenoiu14, Patrick Durez14, Virginia Pascual-Ramos15, Dionicio Angel Galarza-Delgado16, Pompilio Faggiano17, Durga Prasanna Misra18, Andrew Borg19, Rong Mu20, Erkin M Mirrakhimov21, Diane Gheta22, Svetlana Myasoedova23, Lev Krougly24, Tatiana Popkova25, Alena Tuchyňová26, Michal Tomcik27, Michal Vrablik28, Jiri Lastuvka28,29, Pavel Horák30, Helena Medková31, Anne Grete Semb1. 1. Preventive Cardio-Rheuma Clinic, Division of Rheumatology and Research, Diakonhjemmet Hospital, Diakonveien 12, 0370 Oslo, Norway. 2. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. 3. Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. 4. Bernhoven Hospital, Uden, the Netherlands. 5. Dudley Group NHS Foundation Trust, Dudley, West Midlands, UK. 6. Trinity College Dublin, Dublin, Ireland. 7. Swedish Rheumatoid Arthritis Registry, Umeå, Sweden. 8. The Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA. 9. Hospital Universitario Marqués de Valdecilla, Santander, Spain. 10. Joint Rheumatology Program, First Department of Propaedeutic Internal Medicine, Laiko Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. 11. Joint Rheumatology Program, 2nd Department of Medicine and Laboratory, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece. 12. Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada. 13. Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. 14. Rheumatology Department, Cliniques Universitaires Saint Luc, Institut de recherche expérimentale et clinique, Université catholique de Louvain, Brussels, Belgium. 15. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México. 16. Hospital Universitario 'Dr José E. González', UANL, Monterrey, México. 17. Spedali Civili and University of Brescia, Brescia, Italy. 18. Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India. 19. Mater Dei, Msida, Malta. 20. Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China. 21. Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic. 22. Tallagh University Hospital, Dublin, Ireland. 23. Ivanovo State Medical Academy, Ivanovo, Russia. 24. Center of Cardiology of Russian Ministry of Healthcare, Moscow, Russia. 25. V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia. 26. National Institute of Rheumatic Diseases, 92101 Piešťany, Slovensko, Slovakia. 27. Institute of Rheumatology, Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic. 28. Third Department of Internal Medicine, Department of Endocrinology and Metabolism, First Medical Faculty, Charles University and General Faculty Hospital, Prague, Czech Republic. 29. First Medical Faculty, Charles University, Prague, Czech Republic. 30. Iii Interna klinika fn Olomouc, Olomouc, Czech Republic. 31. Division of Rheumatology, 2nd Department of Internal Medicine-Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Hradec Králové, Czech Republic.
Abstract
AIMS: To assess differences in estimated cardiovascular disease (CVD) risk among rheumatoid arthritis (RA) patients from different world regions and to evaluate the management and goal attainment of lipids and blood pressure (BP). METHODS AND RESULTS: The survey of CVD risk factors in patients with RA was conducted in 14 503 patients from 19 countries during 2014-19. The treatment goal for BP was <140/90 mmHg. CVD risk prediction and lipid goals were according to the 2016 European guidelines. Overall, 21% had a very high estimated risk of CVD, ranging from 5% in Mexico, 15% in Asia, 19% in Northern Europe, to 31% in Central and Eastern Europe and 30% in North America. Of the 52% with indication for lipid-lowering treatment (LLT), 44% were using LLT. The lipid goal attainment was 45% and 18% in the high and very high risk groups, respectively. Use of statins in monotherapy was 24%, while 1% used statins in combination with other LLT. Sixty-two per cent had hypertension and approximately half of these patients were at BP goal. The majority of the patients used antihypertensive treatment in monotherapy (24%), while 10% and 5% as a two- or three-drug combination. CONCLUSION: We revealed considerable geographical differences in estimated CVD risk and preventive treatment. Low goal attainment for LLT was observed, and only half the patients obtained BP goal. Despite a high focus on the increased CVD risk in RA patients over the last decade, there is still substantial potential for improvement in CVD preventive measures.
AIMS: To assess differences in estimated cardiovascular disease (CVD) risk among rheumatoid arthritis (RA) patients from different world regions and to evaluate the management and goal attainment of lipids and blood pressure (BP). METHODS AND RESULTS: The survey of CVD risk factors in patients with RA was conducted in 14 503 patients from 19 countries during 2014-19. The treatment goal for BP was <140/90 mmHg. CVD risk prediction and lipid goals were according to the 2016 European guidelines. Overall, 21% had a very high estimated risk of CVD, ranging from 5% in Mexico, 15% in Asia, 19% in Northern Europe, to 31% in Central and Eastern Europe and 30% in North America. Of the 52% with indication for lipid-lowering treatment (LLT), 44% were using LLT. The lipid goal attainment was 45% and 18% in the high and very high risk groups, respectively. Use of statins in monotherapy was 24%, while 1% used statins in combination with other LLT. Sixty-two per cent had hypertension and approximately half of these patients were at BP goal. The majority of the patients used antihypertensive treatment in monotherapy (24%), while 10% and 5% as a two- or three-drug combination. CONCLUSION: We revealed considerable geographical differences in estimated CVD risk and preventive treatment. Low goal attainment for LLT was observed, and only half the patients obtained BP goal. Despite a high focus on the increased CVD risk in RA patients over the last decade, there is still substantial potential for improvement in CVD preventive measures.
Authors: Kristine Røren Nordén; Hanne Dagfinrud; Anne Grete Semb; Jonny Hisdal; Kirsten K Viktil; Joseph Sexton; Camilla Fongen; Jon Skandsen; Thalita Blanck; George S Metsios; Anne Therese Tveter Journal: BMJ Open Date: 2022-02-17 Impact factor: 2.692
Authors: Anne Grete Semb; Silvia Rollefstad; Joseph Sexton; Eirik Ikdahl; Cynthia S Crowson; Piet van Riel; George Kitas; Ian Graham; Anne M Kerola Journal: Int J Cardiol Heart Vasc Date: 2022-09-12