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Cardiovascular risk factor management in patients with RA compared to matched non-RA patients

By E. (Evo) Alemao, H. (Helene) Cawston, F. Bourhis, M.J. (Maiwenn) Al, M.P.M.H. (Maureen) Rutten-van Mölken, K. (Katherine) Liao and D.H. (Daniel) Solomon


Objective. RA is associated with a 50-60% increase in risk of cardiovascular (CV) death. This study aimed\ud to compare management of CV risk factors in RA and matched non-RA patients. \ud Methods. A retrospective cohort study was conducted using UK clinical practice data. Patients presenting\ud with an incident RA diagnosis were matched 1:4 to non-RA patients based on a propensity score for RA,\ud entry year, CV risk category and treatment received at index date (date of RA diagnosis). Patients tested\ud and treated for CV risk factors as well as those attaining CV risk factor management goals were evaluated\ud in both groups. \ud Results. Between 1987 and 2010, 24 859 RA patients were identified and matched to 87 304 non-RA\ud patients. At index date, groups had similar baseline characteristics. Annual blood pressure, lipids and\ud diabetes-related testing were similar in both groups, although CRP and ESR were higher in RA patients at\ud diagnosis and decreased over time. RA patients prescribed antihypertensives increased from 38.2% at\ud diagnosis to 45.7% at 5 years, from 14.0 to 20.6% for lipid-lowering treatments and from 5.1 to 6.4% for\ud antidiabetics. Similar treatment percentages were observed in non-RA patients, although slightly lower for\ud antihypertensives. Modest (2%) but significantly lower attainment of lipid and diabetes goals at 1 year was\ud observed in RA patients. \ud Conclusion. There were no differences between groups in the frequency of testing and treatment of CV\ud risk factors. Higher CV risk in RA patients seems unlikely to be driven by differences in traditional CV risk\ud factor management

Topics: RA, cardiovascular, management, hypertension, dyslipidaemia, diabetes, goal, prescription, cohort
Year: 2015
DOI identifier: 10.1093/rheumatology/kev427
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