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Cardiovascular disease in rheumatoid arthritis: medications and risk factors in China


This study aims to assess the risk factors of cardiovascular disease (CVD) and to determine the association of traditional and biologic disease-modifying anti-rheumatic drugs (DMARDs) with risk for CVD in Chinese rheumatoid arthritis (RA) patients. A cross-sectional cohort of 2013 RA patients from 21 hospitals around China was established. Medical history of CVD was documented. The patients’ social background, clinical manifestations, comorbidities, and medications were also collected. Of the 2013 patients, 256 had CVD with an incidence of 12.7%. Compared with non-CVD controls, RA patients with CVD had a significantly advanced age, long-standing median disease duration, more often male and more deformity joints. Patients with CVD also had higher rates of smoking, rheumatoid nodules, interstitial lung disease, and anemia. The prevalence of comorbidities, including hypothyroidism, diabetes mellitus (DM), hypertension, and hyperlipidemia, was also significant higher in the CVD group. In contrast, patients treated with methotrexate, hydroxychloroquine (HCQ), and TNF blockers had lower incidence of CVD. The multivariate analysis showed that the use of HCQ was a protective factor of CVD, while hypertension, hyperlipidemia, and interstitial lung disease were independent risk factors of CVD. Our study shows that the independent risk factors of CVD include hypertension, hyperlipidemia, and interstitial lung disease. HCQ reduces the risk of CVD in patients with RA.

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We are very grateful to the patients and their families for their cooperation and for giving consent to participate in this study.

Author information

Correspondence to Rong Mu or Z. G. Li.

Ethics declarations

The study was approved by the Ethics Committee of Peking University People’s Hospital, and informed written consents were obtained from all study participants (FWA00001384).




Supported by National High Technology Research and Development Program of China (973 Program, 2012CB517700) and National Natural Science Foundation of China (NSFC, No. 81202297)

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Li, C., Wang, X.R., Ji, H.J. et al. Cardiovascular disease in rheumatoid arthritis: medications and risk factors in China. Clin Rheumatol 36, 1023–1029 (2017).

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  • Cardiovascular disease
  • Rheumatoid arthritis
  • Risk factor