Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis

Michael A Crilly, Vinod V Kumar, Hazel J. Clark, Neil William Scott, Alan G. MacDonald, David J. Williams

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective. To quantify the relationship between arterial stiffness and cumulative inflammatory burden in patients with RA.

Methods. We recruited RA patients without overt arterial disease aged 40-65 years, attending hospital rheumatology outpatient clinics. Standardized research nurse assessment included blood pressure (BP), pulse wave analysis (PWA, SphygmoCor), BMI, fasting blood sample (lipids, glucose, RF and ESR), patient questionnaire (smoking, alcohol, diet, exercise, family history of premature coronary heart disease and Stanford HAQ), current medication and medical record review. Cumulative inflammatory burden was measured as ESR area-under- the-curve (ESR-years) extracted from medical records. Arterial stiffness was measured using PWA [aortic augmentation index (AIX@ 75)]. Multiple linear regression was used to adjust for age, sex and nine other cardiovascular risk factors.

Results. We recruited 114 RA patients (mean age 54 years, female 81%, current DMARD 90%, current NSAID 70%, ACR criteria 56%) comprising 1040 RA person-years. Cholesterol, glucose and BMI were similar in women and men. Women had a longer duration of arthritis (10 vs 7 years) and were more likely to be seropositive (85 vs 71%). BP, smoking and alcohol consumption were lower for women. On fully adjusted analysis, an increase of 100 ESR-years was associated with an increase in AIX@ 75 of 0.51 (95% CI 0.13, 0.88). On fully adjusted analysis restricted to women the increase was 0.43 (95% CI 0.01, 0.85).

Conclusions. In RA patients free of overt arterial disease, a dose-response relationship exists between cumulative inflammatory burden and arterial stiffness. This relationship is independent of established CV risk factors.

Original languageEnglish
Pages (from-to)1606-1612
Number of pages7
JournalRheumatology
Volume48
Issue number12
DOIs
Publication statusPublished - Dec 2009

Keywords

  • RA
  • Inflammation
  • Pulse wave analysis
  • Arterial stiffness
  • Augmentation index
  • Cardiovascular risk factors
  • PULSE-WAVE ANALYSIS
  • CORONARY-HEART-DISEASE
  • BLOOD-PRESSURE
  • ENDOTHELIAL FUNCTION
  • AUGMENTATION INDEX
  • AORTIC PRESSURE
  • ATHEROSCLEROSIS
  • REFLECTIONS
  • VELOCITY
  • TRIAL
  • inflammation
  • pulse wave analysis
  • arterial stiffness
  • augmentation index
  • cardiovascular risk factors

Cite this

Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis. / Crilly, Michael A; Kumar, Vinod V; Clark, Hazel J.; Scott, Neil William; MacDonald, Alan G.; Williams, David J.

In: Rheumatology, Vol. 48, No. 12, 12.2009, p. 1606-1612.

Research output: Contribution to journalArticle

Crilly, Michael A ; Kumar, Vinod V ; Clark, Hazel J. ; Scott, Neil William ; MacDonald, Alan G. ; Williams, David J. / Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis. In: Rheumatology. 2009 ; Vol. 48, No. 12. pp. 1606-1612.
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abstract = "Objective. To quantify the relationship between arterial stiffness and cumulative inflammatory burden in patients with RA.Methods. We recruited RA patients without overt arterial disease aged 40-65 years, attending hospital rheumatology outpatient clinics. Standardized research nurse assessment included blood pressure (BP), pulse wave analysis (PWA, SphygmoCor), BMI, fasting blood sample (lipids, glucose, RF and ESR), patient questionnaire (smoking, alcohol, diet, exercise, family history of premature coronary heart disease and Stanford HAQ), current medication and medical record review. Cumulative inflammatory burden was measured as ESR area-under- the-curve (ESR-years) extracted from medical records. Arterial stiffness was measured using PWA [aortic augmentation index (AIX@ 75)]. Multiple linear regression was used to adjust for age, sex and nine other cardiovascular risk factors.Results. We recruited 114 RA patients (mean age 54 years, female 81{\%}, current DMARD 90{\%}, current NSAID 70{\%}, ACR criteria 56{\%}) comprising 1040 RA person-years. Cholesterol, glucose and BMI were similar in women and men. Women had a longer duration of arthritis (10 vs 7 years) and were more likely to be seropositive (85 vs 71{\%}). BP, smoking and alcohol consumption were lower for women. On fully adjusted analysis, an increase of 100 ESR-years was associated with an increase in AIX@ 75 of 0.51 (95{\%} CI 0.13, 0.88). On fully adjusted analysis restricted to women the increase was 0.43 (95{\%} CI 0.01, 0.85).Conclusions. In RA patients free of overt arterial disease, a dose-response relationship exists between cumulative inflammatory burden and arterial stiffness. This relationship is independent of established CV risk factors.",
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T1 - Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis

AU - Crilly, Michael A

AU - Kumar, Vinod V

AU - Clark, Hazel J.

AU - Scott, Neil William

AU - MacDonald, Alan G.

AU - Williams, David J.

PY - 2009/12

Y1 - 2009/12

N2 - Objective. To quantify the relationship between arterial stiffness and cumulative inflammatory burden in patients with RA.Methods. We recruited RA patients without overt arterial disease aged 40-65 years, attending hospital rheumatology outpatient clinics. Standardized research nurse assessment included blood pressure (BP), pulse wave analysis (PWA, SphygmoCor), BMI, fasting blood sample (lipids, glucose, RF and ESR), patient questionnaire (smoking, alcohol, diet, exercise, family history of premature coronary heart disease and Stanford HAQ), current medication and medical record review. Cumulative inflammatory burden was measured as ESR area-under- the-curve (ESR-years) extracted from medical records. Arterial stiffness was measured using PWA [aortic augmentation index (AIX@ 75)]. Multiple linear regression was used to adjust for age, sex and nine other cardiovascular risk factors.Results. We recruited 114 RA patients (mean age 54 years, female 81%, current DMARD 90%, current NSAID 70%, ACR criteria 56%) comprising 1040 RA person-years. Cholesterol, glucose and BMI were similar in women and men. Women had a longer duration of arthritis (10 vs 7 years) and were more likely to be seropositive (85 vs 71%). BP, smoking and alcohol consumption were lower for women. On fully adjusted analysis, an increase of 100 ESR-years was associated with an increase in AIX@ 75 of 0.51 (95% CI 0.13, 0.88). On fully adjusted analysis restricted to women the increase was 0.43 (95% CI 0.01, 0.85).Conclusions. In RA patients free of overt arterial disease, a dose-response relationship exists between cumulative inflammatory burden and arterial stiffness. This relationship is independent of established CV risk factors.

AB - Objective. To quantify the relationship between arterial stiffness and cumulative inflammatory burden in patients with RA.Methods. We recruited RA patients without overt arterial disease aged 40-65 years, attending hospital rheumatology outpatient clinics. Standardized research nurse assessment included blood pressure (BP), pulse wave analysis (PWA, SphygmoCor), BMI, fasting blood sample (lipids, glucose, RF and ESR), patient questionnaire (smoking, alcohol, diet, exercise, family history of premature coronary heart disease and Stanford HAQ), current medication and medical record review. Cumulative inflammatory burden was measured as ESR area-under- the-curve (ESR-years) extracted from medical records. Arterial stiffness was measured using PWA [aortic augmentation index (AIX@ 75)]. Multiple linear regression was used to adjust for age, sex and nine other cardiovascular risk factors.Results. We recruited 114 RA patients (mean age 54 years, female 81%, current DMARD 90%, current NSAID 70%, ACR criteria 56%) comprising 1040 RA person-years. Cholesterol, glucose and BMI were similar in women and men. Women had a longer duration of arthritis (10 vs 7 years) and were more likely to be seropositive (85 vs 71%). BP, smoking and alcohol consumption were lower for women. On fully adjusted analysis, an increase of 100 ESR-years was associated with an increase in AIX@ 75 of 0.51 (95% CI 0.13, 0.88). On fully adjusted analysis restricted to women the increase was 0.43 (95% CI 0.01, 0.85).Conclusions. In RA patients free of overt arterial disease, a dose-response relationship exists between cumulative inflammatory burden and arterial stiffness. This relationship is independent of established CV risk factors.

KW - RA

KW - Inflammation

KW - Pulse wave analysis

KW - Arterial stiffness

KW - Augmentation index

KW - Cardiovascular risk factors

KW - PULSE-WAVE ANALYSIS

KW - CORONARY-HEART-DISEASE

KW - BLOOD-PRESSURE

KW - ENDOTHELIAL FUNCTION

KW - AUGMENTATION INDEX

KW - AORTIC PRESSURE

KW - ATHEROSCLEROSIS

KW - REFLECTIONS

KW - VELOCITY

KW - TRIAL

KW - inflammation

KW - pulse wave analysis

KW - arterial stiffness

KW - augmentation index

KW - cardiovascular risk factors

U2 - 10.1093/rheumatology/kep305

DO - 10.1093/rheumatology/kep305

M3 - Article

VL - 48

SP - 1606

EP - 1612

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 12

ER -