Women with seropositive-RA may have increased cardiovascular, respiratory risks

Following an analysis of data from the Nurses’ Health Study, researchers at Brigham and Women’s Hospital in Boston reported an increased risk of cardiovascular and respiratory conditions for women with rheumatoid arthritis compared to women with seronegative-rheumatoid arthritis and the general population.

A group of 119,209 women aged 30 years to 55 years who were enrolled in the Nurses’ Health Study were followed from 1976 to 2012. Women selected from the study did not have rheumatoid arthritis (RA) at baseline.

Researchers found 964 women were later diagnosed with RA. The mean age at diagnosis was 42.4 years, and the women who developed RA consumed less alcohol and were more likely to smoke at baseline than women who did not develop RA.

During follow-up, 307 deaths among women with RA (31.8%) and 28,501 deaths among women without RA (24.1%) were recorded. Cancer was the leading cause of death among women with RA (26.1%) and of women without RA (40.6%). Cardiovascular deaths occurred in 22.8% of women with RA and 21.8% of women without RA. Respiratory causes were cited in 14.3% of deaths in women with RA and in 7.2% of deaths in women without RA.

After adjusting for variables, such as age, time period, income, pack-years of smoking and BMI, investigators found total mortality was significantly higher for women with RA compared to women without RA, and rates remained similar after adjustments for never, past and current smoking status in lieu of cumulative pack-years. However, no significant association was observed between total mortality and seronegative women with RA.

The risk for cardiovascular mortality was significantly higher for women with RA compared to women without RA (with a hazard ratio of 1.45), and an increased risk in seronegative women with RA only trended toward significance. Compared to age- and time period-matched women without RA, a lower survival rate following diagnosis of RA was seen for women with the disease but not for women with seronegative RA.

“Previous studies have suggested that RA may be associated with increased mortality, but were not able to control for other variables, such as smoking, that affect both RA and mortality risks,” Jeffrey Sparks, MD, MMSc, a physician in the Division of Rheumatology, Immunology and Allergy at Brigham and Women’s Hospital, stated in a press release. “Because the Nurses’ Health Study is so large and has been following participants for so long, we were able to gather much more information about our subjects — we could follow them before and after diagnosis, take their health behaviors into account and determine specific causes of death. By doing so, we found strong evidence of increased risk for respiratory, cardiovascular and overall mortality for patients with RA.” – by Shirley Pulawski

Reference:

www.brighamandwomens.org/about_bwh/publicaffairs/news/PressReleases/PressRelease.aspx?sub=0&PageID=2199.

Disclosure s : Sparks reports support from the Rheumatology Research Foundation Scientist Development Award and the National Institutes of Health Loan Repayment Award (L30 AR066953). Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Sparks JA. et al. Arth Care Res. 2015;doi:10.1002/acr.22752.