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Recognition and control of hypertension, diabetes, and dyslipidemia in patients with rheumatoid arthritis

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Abstract

Absolute cardiovascular risk of an individual with rheumatoid arthritis (RA) is greater when compared to the general population, and several factors have proven to be important for the development of coronary artery disease (CAD) in these patients, including factors related to the underlying disease, such as the systemic inflammatory response, drugs used in its treatment, and a higher prevalence of traditional risk factors for CAD. Our aim is to describe the recognition and control frequencies of systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM) in RA patients. Patients with RA answered a questionnaire focused on their general knowledge of the risk factors for CAD, as well as on the recognition of the risk factors that they possess. The patient’s information, collected from a structured medical record, was reviewed to evaluate the control of risk factors. Hundred and thirty-four patients were included in the study. One patient was excluded due to the impossibility of reviewing her medical records. Therefore, 133 patients remained in the study. Patients had a mean (SD) age of 57.3 (12.9) years. SAH was diagnosed in 88 subjects, with a recognition frequency of 89.8%, and 63.3% had desirable blood pressure control. Seventy-two patients were diagnosed with dyslipidemia; 68.1% recognized that they had dyslipidemia and 69.4% achieved desirable LDL-c control. Twenty-two patients had DM; 90.9% admitted being diabetic and 40.9% had desirable glycemic control. The frequencies of the CAD risk factor recognition and control were high in comparison to those described for the general population.

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References

  1. Peters MJL, van Halm VP, Voskuyl AE et al (2009) Does rheumatoid arthritis equal diabetes mellitus as an independent risk factor for cardiovascular disease? A prospective study. Arthritis Care Res 61:1571–1579. https://doi.org/10.1002/art.24836

    Article  Google Scholar 

  2. Symmons DPM, Gabriel SE (2011) Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE. Nat Rev Rheumatol 7:399–408. https://doi.org/10.1038/nrrheum.2011.75

    Article  PubMed  Google Scholar 

  3. Peters MJL, Nurmohamed MT (2013) Cardiovascular risk management in rheumatoid arthritis: are we still waiting for the first step? Arthritis Res Ther 15:111. https://doi.org/10.1186/ar4185

    Article  PubMed  PubMed Central  Google Scholar 

  4. Du Pasquier S, Aslani P (2008) Concordance-based adherence support service delivery: consumer perspectives. Pharm World Sci 30:846–853. https://doi.org/10.1007/s11096-008-9237-0

    Article  PubMed  Google Scholar 

  5. Lee NL, Yu C-M, Lam Y-Y et al (2013) Patient awareness of serious consequences of non-adherence to antiplatelet therapy after coronary stenting. Int J Cardiol 166:278–279. https://doi.org/10.1016/j.ijcard.2012.09.147

    Article  PubMed  Google Scholar 

  6. Chung CP, Giles JT, Petri M et al (2012) Prevalence of traditional modifiable cardiovascular risk factors in patients with rheumatoid arthritis: comparison with control subjects from the multi-ethnic study of atherosclerosis. Semin Arthritis Rheum 41:535–544. https://doi.org/10.1016/j.semarthrit.2011.07.004

    Article  PubMed  PubMed Central  Google Scholar 

  7. Aletaha D, Neogi T, Silman AJ et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581. https://doi.org/10.1002/art.27584

    Article  PubMed  Google Scholar 

  8. Associação Brasileira de Empresas de Pesquisa (2015) Critério de Classificação econômica Brasil. Critério Brasil ABEP. https://www.abep.org/criterio-brasil. Accessed 10 Nov 2015

  9. Schoenborn CA, Stephens T (1988) Health promotion in the United States and Canada: smoking, exercise, and other health-related behaviors. Am J Public Health 78:983–984

    Article  CAS  Google Scholar 

  10. Xavier HT, Faria Neto JR, Assad MH et al (2013) V Brazilian guidelines on dyslipidemias and prevention of atherosclerosis. Arq Bras Cardiol 101:1–20. https://doi.org/10.5935/abc.2013S010

    Article  CAS  PubMed  Google Scholar 

  11. American Diabetes Association (2015) Classification and diagnosis of diabetes. Diabetes Care 38:S8–S16. https://doi.org/10.2337/dc15-S005

    Article  Google Scholar 

  12. Sociedade Brasileira de Cardiologia / Sociedade Brasileira de Hipertensão / Sociedade Brasileira de Nefrologia (2010) VI Diretrizes brasileiras de hipertensão. Arq Bras Cardiol 95(1 supl.1): 1–51

    Google Scholar 

  13. Chung CP, Oeser A, Raggi P et al (2005) Increased coronary-artery atherosclerosis in rheumatoid arthritis: relationship to disease duration and cardiovascular risk factors. Arthritis Rheum 52:3045–3053. https://doi.org/10.1002/art.21288

    Article  PubMed  Google Scholar 

  14. Maradit-Kremers H, Crowson CS, Nicola PJ et al (2005) Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 52:402–411. https://doi.org/10.1002/art.20853

    Article  PubMed  Google Scholar 

  15. McEntegart A, Capell HA, Creran D et al (2001) Cardiovascular risk factors, including thrombotic variables, in a population with rheumatoid arthritis. Rheumatol Oxf Engl 40:640–644

    Article  CAS  Google Scholar 

  16. Giles JT, Danielides S, Szklo M et al (2015) Insulin resistance in rheumatoid arthritis: disease-related indicators and associations with the presence and progression of subclinical atherosclerosis. Arthritis Rheumatol 67:626–636. https://doi.org/10.1002/art.38986

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Boo S, Oh H, Froelicher ES, Suh C-H (2017) Knowledge and perception of cardiovascular disease risk among patients with rheumatoid arthritis. PLOS One 12:e0176291. https://doi.org/10.1371/journal.pone.0176291

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Danon-Hersch N, Marques-Vidal P, Bovet P et al (2009) Prevalence, awareness, treatment and control of high blood pressure in a Swiss city general population: the CoLaus study. Eur J Cardiovasc Prev Rehabil 16:66–72. https://doi.org/10.1097/HJR.0b013e32831e9511

    Article  PubMed  Google Scholar 

  19. McDonald M, Hertz RP, Unger AN, Lustik MB (2009) Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older. J Gerontol A Biol Sci Med Sci 64:256–263. https://doi.org/10.1093/gerona/gln016

    Article  PubMed  Google Scholar 

  20. Chor D, Pinho Ribeiro AL, Sá Carvalho M et al (2015) Prevalence, awareness, treatment and influence of socioeconomic variables on control of high blood pressure: results of the ELSA-Brasil study. PloS One 10:e0127382. https://doi.org/10.1371/journal.pone.0127382

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. He H, Yu Y, Li Y et al (2014) Dyslipidemia awareness, treatment, control and influence factors among adults in the Jilin province in China: a cross-sectional study. Lipids Health Dis 13:122. https://doi.org/10.1186/1476-511X-13-122

    Article  PubMed  PubMed Central  Google Scholar 

  22. Huang Y, Gao L, Xie X, Tan SC (2014) Epidemiology of dyslipidemia in Chinese adults: meta-analysis of prevalence, awareness, treatment, and control. Popul Health Metr 12:28. https://doi.org/10.1186/s12963-014-0028-7

    Article  PubMed  PubMed Central  Google Scholar 

  23. Alkerwi A, Pagny S, Lair M-L et al (2013) Level of unawareness and management of diabetes, hypertension, and dyslipidemia among adults in Luxembourg: findings from ORISCAV-LUX study. PloS One 8(3):e57920. https://doi.org/10.1371/journal.pone.0057920

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Mankad R (2015) Atherosclerotic vascular disease in the autoimmune rheumatologic patient. Curr Atheroscler Rep 17:21. https://doi.org/10.1007/s11883-015-0497-6

    Article  CAS  Google Scholar 

  25. Jafri K, Taylor L, Nezamzadeh M et al (2015) Management of hyperlipidemia among patients with rheumatoid arthritis in the primary care setting. BMC Musculoskelet Disord 16:237. https://doi.org/10.1186/s12891-015-0700-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Veetil BMA, Myasoedova E, Matteson EL et al (2013) Use of lipid lowering agents in rheumatoid arthritis: a population based cohort study. J Rheumatol 40:1082–1088. https://doi.org/10.3899/jrheum.121302

    Article  CAS  PubMed Central  Google Scholar 

  27. Panoulas VF, Douglas KMJ, Milionis HJ et al (2007) Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis. Rheumatology 46:1477–1482. https://doi.org/10.1093/rheumatology/kem169

    Article  CAS  PubMed  Google Scholar 

  28. Picon RV, Fuchs FD, Moreira LB et al (2012) Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis. PloS One 7:e48255. https://doi.org/10.1371/journal.pone.0048255

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Fasce E, Campos I, Ibáñez P et al (2007) Trends in prevalence, awareness, treatment and control of hypertension in urban communities in Chile. J Hypertens 25:1807–1811. https://doi.org/10.1097/HJH.0b013e328244e481

    Article  CAS  PubMed  Google Scholar 

  30. Guo F, He D, Zhang W, Walton RG (2012) Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999 to 2010. J Am Coll Cardiol 60:599–606. https://doi.org/10.1016/j.jacc.2012.04.026

    Article  PubMed  Google Scholar 

  31. McAlister FA, Wilkins K, Joffres M et al (2011) Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades. CMAJ 183:1007–1013. https://doi.org/10.1503/cmaj.101767

    Article  PubMed  PubMed Central  Google Scholar 

  32. Goff DC, Bertoni AG, Kramer H et al (2006) Dyslipidemia prevalence, treatment, and control in the multi-ethnic study of atherosclerosis (MESA) gender, ethnicity, and coronary artery calcium. Circulation 113:647–656. https://doi.org/10.1161/CIRCULATIONAHA.105.552737

    Article  CAS  PubMed  Google Scholar 

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Funding

This study was financially supported by Coordination for the Improvement of Higher Education Personnel (CAPES). Dr. Ribeiro was supported in part by CNPq (Bolsa de produtividade em pesquisa, 310679/2016-8) and by FAPEMIG (Programa Pesquisador Mineiro, PPM-00428-17).

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Authors and Affiliations

  1. Hospital das Clínicas e Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais, 30130-100, Brazil

    Luísa Lima Castro, Cristina Costa Duarte Lanna, Mariana Pimenta Rocha, Antônio Luiz Pinho Ribeiro & Rosa Weiss Telles

Authors
  1. Luísa Lima Castro
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  2. Cristina Costa Duarte Lanna
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  3. Mariana Pimenta Rocha
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  4. Antônio Luiz Pinho Ribeiro
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  5. Rosa Weiss Telles
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Contributions

LLC: data collection, manuscript writing, and statistical analysis. RWT: manuscript revision, and statistical analysis. CCDL: manuscript revision and statistical analysis. MPR: data collection. ALPR: manuscript revision and statistical analysis.

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Correspondence to Luísa Lima Castro.

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Castro, L.L., Lanna, C.C.D., Rocha, M.P. et al. Recognition and control of hypertension, diabetes, and dyslipidemia in patients with rheumatoid arthritis. Rheumatol Int 38, 1437–1442 (2018). https://doi.org/10.1007/s00296-018-4084-3

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  • DOI: https://doi.org/10.1007/s00296-018-4084-3

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