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To assess in one-time window cardiovascular risks for both patients with gout and patients with rheumatoid arthritis in a Dutch primary care population.
It has been
previously said that the risk of cardiovascular (CV) disease is increased among
both rheumatoid arthritis (RA) and gout patients. This study furnishes us with
the proper primary care guidelines on cardiovascular risk management for the
same.
To assess in
one-time window cardiovascular risks for both patients with gout and patients
with rheumatoid arthritis in a Dutch primary care population.
Retrospective
matched cohort study with data from the electronic health records of 51 Dutch
general practices. Participants were patients aged 30 years or older with an
incident diagnosis of gout (n = 2655) or rheumatoid arthritis (n = 513), and
matched non-disease controls (n = 7891 and n = 1850 respectively). At disease
incidence date, patients and controls were compared for prevalence of
hypertension, diabetes mellitus, hypercholesterolemia, and prior cardiovascular
diseases. Patients without prior cardiovascular disease were followed for a
first cardiovascular disease, and compared to controls using Kaplan-Meier
survival curves and Cox proportional hazard analyses.
Compared to
controls, gout patients suffered more from hypertension (44.8%), diabetes
(20.1%), hypercholesterolemia (13.7%), and prior cardiovascular disease (30%)
(P < 0.01), whereas rheumatoid arthritis patients (hypertension 28.5%;
diabetes 11.7%; hypercholesterolemia 7.4%; prior cardiovascular disease 11.3%)
did not (P > 0.05). After adjustment, both gout and rheumatoid arthritis
patients without prior cardiovascular disease were more likely to get a
cardiovascular disease: hazard ratio (95% confidence interval) 1.44 (1.18 to
1.76), and 2.06 (1.34 to 3.16) respectively.
This primary care
study indicates that gout and rheumatoid arthritis are both independent risk
factors for cardiovascular diseases, rheumatoid arthritis to some greater
extent, whereas gout patients at first diagnosis had already an increased
cardiovascular risk profile. It gives strong arguments for implementation of
both rheumatic diseases in primary care guidelines on cardiovascular risk
management.
Joint Bone Spine
Gout and rheumatoid arthritis, both to keep in mind in cardiovascular risk management: A primary care retrospective cohort study
Hein J.E.M. Janssens et al.
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