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Heartbeat: Chronic inflammatory disorders and cardiovascular disease
  1. Catherine M Otto
  1. Correspondence to Professor Catherine M Otto, Division of Cardiology, University of Washington, Seattle, WA 98195, USA; cmotto{at}

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Inflammation is thought to be a key pathophysiologic factor in atherosclerotic cardiovascular disease (CVD). In addition, patients with systemic inflammatory disorders, such as rheumatoid arthritis (RA), are at increased risk of CVD events, possibly modulated by disease-modifying anti-inflammatory therapy.1–3 However, few studies have examined whether these patients receive appropriate evaluation and treatment for conventional CVD risk factors in the primary care setting.

In this issue of Heart, Emanuel and colleagues (see page 1957) used electronic primary care health records to evaluate CVD risk factor measurement and treatment in 1121 RA and 1875 inflammatory bowel disease (IBD) patients compared to control patients without these conditions. Evaluation of CVD risk factors was incomplete in most patients, with adequate data recorded for calculation of risk scores in only 11% of RA patients and 9% of IBD patients (figure 1). On the other hand, prescription rates for antihypertensive medications in patients with RA were higher compared to controls over 5 years of follow-up (OR, 1.37, 95% CI 1.14 to 1.65). A video abstract is also available for this article.

Figure 1

Cumulative trends in recording of vascular risk factors from the year before and up to 5 years following disease diagnosis in patients and controls. (A) Patients with …

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