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Managing cardiovascular risk in patients with chronic inflammatory diseases

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Abstract

The role of traditional risk factors in the development of cardiovascular disease has been well studied. However, the relationship between chronic inflammatory conditions and cardiovascular risk has only recently been appreciated. Expression of numerous pro-inflammatory cytokines is common to the pathogenesis of both atherosclerosis and other chronic inflammatory diseases and may suggest that systemic inflammation independently contributes to elevated risk. This article examines the magnitude of cardiovascular risk in several of the most common chronic inflammatory diseases and summarizes currently available data to discern whether this risk is largely due to the presence of co-existing traditional risk factors for cardiovascular disease or the effect of increased systemic inflammation. Evidence is summarized to show which therapies may positively or negatively impact cardiovascular risk. Evidence is discussed in context of practical patient management tools, appropriate treatment based on risk, and treatment targets for high-risk patients. Overall, patients with chronic inflammatory diseases are at an often underestimated increase in cardiovascular risk and require individualized therapy and specific patient management strategies to address the disease process, cardiovascular risk factors, and comorbidities.

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Acknowledgments

The original concept and outline for this manuscript was proposed by Dr. Kim Papp. We thank William Mann, BSc, from The Synapse Group, who provided medical writing assistance in the form of editing and drafting based on direction provided by authors and in accordance with standards set out by the International Committee of Medical Journal Editors. Medical writing support was funded by Amgen Canada Inc and Pfizer Canada.

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Authors and Affiliations

  1. Rheumatology, CHUM, Hôpital Notre-Dame, 1560 Sherbrooke Est, Montréal, QC, H2L 4M1, Canada

    Boulos Haraoui

  2. Peter Munk Cardiac Centre, University Health Network, NCSB 11-1266, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada

    Peter P. Liu

  3. Probity Medical Research, 135 Union Street East, Waterloo, ON, N2J 1C4, Canada

    Kim A. Papp

Authors
  1. Boulos Haraoui
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  2. Peter P. Liu
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  3. Kim A. Papp
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Correspondence to Kim A. Papp.

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Haraoui, B., Liu, P.P. & Papp, K.A. Managing cardiovascular risk in patients with chronic inflammatory diseases. Clin Rheumatol 31, 585–594 (2012). https://doi.org/10.1007/s10067-011-1921-0

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