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The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis


Cardiovascular disease (CVD) morbidity and mortality is highly prevalent in patients with rheumatoid arthritis (RA) with debilitating effects for the individual as well as significant healthcare impact. Current evidence demonstrates that engaging in aerobic and resistance exercise (i.e. structured physical activity) can significantly improve patient-reported and clinical index-assessed outcomes in RA. In addition to this, engagement in exercise programmes improves, in a dose-dependent manner, the risk of developing CVD as well as CVD symptoms and outcomes. The present narrative review uses evidence from systematic reviews and meta-analyses as well as controlled trials, to synthesize the current state-of-the-art on the potential effects of aerobic and resistance exercise on CVD risk factors as well as on cardiac and vascular function and structure in people with RA. Where there is a lack of evidence in RA to explain potential mechanisms, relevant studies from the general population are also discussed and linked to RA.

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by GSM, PV and KT. The first draft of the manuscript was written by GSM and GDK and all authors commented on all versions of the manuscript and provided relevant comments for further amending the manuscript and produce the final draft. All authors read and approved the final manuscript.

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Correspondence to George S. Metsios.

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Metsios, G.S., Moe, R.H., van der Esch, M. et al. The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis. Rheumatol Int 40, 347–357 (2020).

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  • Exercise
  • Physical activity
  • Rheumatoid arthritis
  • Non-communicable disease
  • Autoimmune disease
  • Cardiovascular disease
  • Inflammation
  • Rehabilitation