Arthritis patients ‘face higher risk of heart attack with no warning’

PEOPLE with arthritis are more likely to suffer a heart attack without any warning signs, according to a study.

Researchers found that a quarter of patients with rheumatoid arthritis who had no symptoms of heart disease actually had the condition.

This means they were at an increased risk of having a heart attack without warning.

And the higher risk associated with arthritis was independent of more well-known risk factors for heart disease such as smoking and diabetes.

The Mexican study looked for evidence of coronary heart disease in 91 patients with rheumatoid arthritis who had no symptoms of heart problems.

More than half (55 per cent) had high levels of fat in their blood, including cholesterol, and a third (32 per cent) had high blood pressure – which both increase the risk of heart disease. But almost one in four (24 per cent) of the arthritis patients already had coronary heart disease – but had experienced no symptoms and had no idea they were at risk.

Researcher Adriana Puente, a cardiologist at the National Medical Centre in Mexico, said rheumatoid arthritis can nearly double the risk of heart attack overall but the study highlighted the danger to those who could suffer an attack ‘without prior warning’.

‘Most patients never knew they had heart disease and were never alerted about their cardiovascular risk,’ she warned.

Dr Puente said a reason for the link between the two diseases could be that the inflammation caused by rheumatoid arthritis worsens narrowing of the arteries, which leads to heart attacks. She went on: ‘The results highlight the importance of conducting diag- nostic tests in patients with rheumatoid arthritis to see if they have cardiovascular disease, specifically coronary artery disease, even if they have no symptoms and regardless of whether they have cardiovascular risk factors. This is essential to prevent and reduce cardiovascular mortality.’

Dr Puente, who presented her findings at a medical conference in Madrid, concluded: ‘Patients with rheumatoid arthritis should be told that they have an elevated predisposition to heart disease and need treatment to diminish the inflammatory process.

‘They also need advice on how best to control their arthritis and decrease their cardiovascular risk factors.’

She also warned that some medications for rheumatoid arthritis make patients susceptible to elevated levels of fat and a protein called homocysteine in the blood, which are ‘both cardiovascular risk factors and require preventative treatment’.