Skip Navigation


Rheumatology Advance Access originally published online on October 25, 2009
Rheumatology 2009 48(12):1606-1612; doi:10.1093/rheumatology/kep305
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Supplementary Data
Right arrow All Versions of this Article:
48/12/1606    most recent
kep305v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Crilly, M. A.
Right arrow Articles by Williams, D. J.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Crilly, M. A.
Right arrow Articles by Williams, D. J.
Related Collections
Right arrow Rheumatoid Arthritis
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis: a dose–response relationship independent of established cardiovascular risk factors

Michael A. Crilly1, Vinod Kumar2, Hazel J. Clark3, Neil W. Scott1, Alan G. MacDonald4 and David J. Williams3

1Institute of Applied Health Sciences, Aberdeen University Medical School, Aberdeen, 2Department of Rheumatology, Ninewells Hospital, Dundee, 3Department of Clinical Pharmacology and 4Department of Rheumatology, Aberdeen Royal Infirmary, Aberdeen, UK.

Correspondence to: Michael A. Crilly, Institute of Applied Health Sciences, Section of Population Health, Aberdeen University Medical School, Polwarth Building at Foresterhill, Aberdeen AB25 2ZD, UK. E-mail: mike.crilly{at}abdn.ac.uk


  Abstract

Objective. To quantify the relationship between arterial stiffness and cumulative inflammatory burden in patients with RA.

Methods. We recruited RA patients without overt arterial disease aged 40–65 years, attending hospital rheumatology outpatient clinics. Standardized research nurse assessment included blood pressure (BP), pulse wave analysis (PWA, SphygmoCor), BMI, fasting blood sample (lipids, glucose, RF and ESR), patient questionnaire (smoking, alcohol, diet, exercise, family history of premature coronary heart disease and Stanford HAQ), current medication and medical record review. Cumulative inflammatory burden was measured as ESR area-under-the-curve (ESR-years) extracted from medical records. Arterial stiffness was measured using PWA [aortic augmentation index (AIX@75)]. Multiple linear regression was used to adjust for age, sex and nine other cardiovascular risk factors.

Results. We recruited 114 RA patients (mean age 54 years, female 81%, current DMARD 90%, current NSAID 70%, ACR criteria 56%) comprising 1040 RA person-years. Cholesterol, glucose and BMI were similar in women and men. Women had a longer duration of arthritis (10 vs 7 years) and were more likely to be seropositive (85 vs 71%). BP, smoking and alcohol consumption were lower for women. On fully adjusted analysis, an increase of 100 ESR-years was associated with an increase in AIX@75 of 0.51 (95% CI 0.13, 0.88). On fully adjusted analysis restricted to women the increase was 0.43 (95% CI 0.01, 0.85).

Conclusions. In RA patients free of overt arterial disease, a dose–response relationship exists between cumulative inflammatory burden and arterial stiffness. This relationship is independent of established CV risk factors.

KEY WORDS: RA, Inflammation, Pulse wave analysis, Arterial stiffness, Augmentation index, Cardiovascular risk factors

Submitted 17 April 2009; revised version accepted 14 August 2009.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.