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

被引:37
作者
Crilly, Michael A. [1 ]
Kumar, Vinod [2 ]
Clark, Hazel J. [3 ]
Scott, Neil W.
MacDonald, Alan G. [4 ]
Williams, David J. [3 ]
机构
[1] Univ Aberdeen, Sch Med, Inst Appl Hlth Sci, Sect Populat Hlth, Aberdeen AB25 2ZD, Scotland
[2] Ninewells Hosp, Dept Rheumatol, Dundee DD1 9SY, Scotland
[3] Aberdeen Royal Infirm, Dept Clin Pharmacol, Aberdeen, Scotland
[4] Aberdeen Royal Infirm, Dept Rheumatol, Aberdeen, Scotland
关键词
RA; Inflammation; Pulse wave analysis; Arterial stiffness; Augmentation index; Cardiovascular risk factors; PULSE-WAVE ANALYSIS; CORONARY-HEART-DISEASE; BLOOD-PRESSURE; ENDOTHELIAL FUNCTION; AUGMENTATION INDEX; AORTIC PRESSURE; ATHEROSCLEROSIS; REFLECTIONS; VELOCITY; TRIAL;
D O I
10.1093/rheumatology/kep305
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:1606 / 1612
页数:7
相关论文
共 40 条
[1]   THE AMERICAN-RHEUMATISM-ASSOCIATION 1987 REVISED CRITERIA FOR THE CLASSIFICATION OF RHEUMATOID-ARTHRITIS [J].
ARNETT, FC ;
EDWORTHY, SM ;
BLOCH, DA ;
MCSHANE, DJ ;
FRIES, JF ;
COOPER, NS ;
HEALEY, LA ;
KAPLAN, SR ;
LIANG, MH ;
LUTHRA, HS ;
MEDSGER, TA ;
MITCHELL, DM ;
NEUSTADT, DH ;
PINALS, RS ;
SCHALLER, JG ;
SHARP, JT ;
WILDER, RL ;
HUNDER, GG .
ARTHRITIS AND RHEUMATISM, 1988, 31 (03) :315-324
[2]   Forearm haemodynamics, arterial stiffness and microcirculatory reactivity in rheumatoid arthritis [J].
Arosio, Enrico ;
De Marchi, Sergio ;
Rigoni, Anna ;
Prior, Manlio ;
Delva, Pietro ;
Lechi, Alessandro .
JOURNAL OF HYPERTENSION, 2007, 25 (06) :1273-1278
[3]  
Avalos I, 2007, J RHEUMATOL, V34, P2388
[4]   Risk of Cardiovascular Mortality in Patients With Rheumatoid Arthritis: A Meta-Analysis of Observational Studies [J].
Avina-Zubieta, J. Antonio ;
Choi, Hyon K. ;
Sadatsafavi, Mohsen ;
Etminan, Mahyar ;
Esdaile, John M. ;
Lacaille, Diane .
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH, 2008, 59 (12) :1690-1697
[5]  
Book C, 2005, J RHEUMATOL, V32, P430
[6]   The Stanford Health Assessment Questionnaire: Dimensions and Practical Applications [J].
Bonnie Bruce ;
James F Fries .
Health and Quality of Life Outcomes, 1 (1)
[7]   Indices of cardiovascular function derived from peripheral pulse wave analysis using radial applanation tonometry: a measurement repeatability study [J].
Crilly, Mike ;
Coch, Christoph ;
Bruce, Margaret ;
Clark, Hazel ;
Williams, David .
VASCULAR MEDICINE, 2007, 12 (03) :189-197
[8]  
Cypiene Alma, 2007, Proc West Pharmacol Soc, V50, P119
[9]   Haematocrit, viscosity, erythrocyte sedimentation rate: meta-analyses of prospective studies of coronary heart disease [J].
Danesh, J ;
Collins, R ;
Peto, R ;
Lowe, GDO .
EUROPEAN HEART JOURNAL, 2000, 21 (07) :515-520
[10]   C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease [J].
Danesh, J ;
Wheeler, JG ;
Hirschfield, GM ;
Eda, S ;
Eiriksdottir, G ;
Rumley, A ;
Lowe, GDO ;
Pepys, MB ;
Gudnason, V .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (14) :1387-1397