Managing Cardiovascular Disease Risk in Rheumatoid Arthritis: Clinical Updates and Three Strategic Approaches

被引:32
作者
Chodara, Ann M. [1 ]
Wattiaux, Aimee [2 ]
Bartels, Christie M. [2 ]
机构
[1] Univ Wisconsin Hosp & Clin, Dept Med, Madison, WI 53792 USA
[2] UW, Dept Med, Div Rheumatol, SMPH, 1685 Highland Ave,Rm 4132, Madison, WI 53705 USA
关键词
Rheumatoid arthritis; Cardiovascular disease; Risk assessment; Hypertension; Hyperlipidemia; Smoking cessation; RANDOMIZED CONTROLLED-TRIAL; ACUTE MYOCARDIAL-INFARCTION; INTIMA-MEDIA THICKNESS; CORONARY-HEART-DISEASE; TREAT-TO-TARGET; SMOKING-CESSATION; SUBCLINICAL ATHEROSCLEROSIS; QUALITY INDICATORS; ENDOTHELIAL DYSFUNCTION; STATIN DISCONTINUATION;
D O I
10.1007/s11926-017-0643-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The increase in cardiovascular disease (CVD) risk in rheumatoid arthritis (RA) is well known; however, appropriate management of this elevated risk in rheumatology clinics is less clear. Purpose of Review By critically reviewing literature published within the past 5 years, we aim to clarify current knowledge and gaps regarding CVD risk management in RA. Recent Findings We examine recent guidelines, recommendations, and evidence and discuss three approaches: (1) RA-specificmanagement including treat-to-target andmedication management, (2) assessment of comprehensive individual risk, and (3) targeting traditional CVD risk factors (hypertension, smoking, hyperlipidemia, diabetes, obesity, and physical inactivity) at a population level. Considering that 75% of US RA visits occur in specialty clinics, further research is needed regarding evidence-based strategies to manage and reduce CVD risk in RA. Summary This review highlights clinical updates including US cardiology and international professional society guidelines, successful evidence-based population approaches from primary care, and novel opportunities in rheumatology care to reduce CVD risk in RA.
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页数:11
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