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Suboptimal assessment of vascular risk in rheumatoid arthritis and inflammatory bowel disease
Patients in primary care
A recent matched cohort study using primary care electronic health records for one London borough indicates that only a minority of patients with rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) are assessed for the presence of cardiovascular (CV) disease risk factors in primary care settings.1
CV disease is one of the leading causes of comorbidity in patients with chronic inflammatory diseases. It is especially true for patients with inflammatory arthritis. In this regard, the risk of CV events in patients with RA, psoriatic arthritis and ankylosing spondylitis is significantly increased compared with the general population.2
Although the reasons for the augmented CV mortality due to CV events in patients with chronic inflammatory conditions are not fully understood, the combined effect of classic (traditional) CV risk factors and a chronic inflammatory burden along with a genetic component is known to account for the development of accelerated atherosclerosis in these patients.3
Recent data fully support previous studies that highlighted an increased frequency of traditional CV risk factors in patients with chronic inflammatory diseases.2 ,4 Besides adequate treatment of the inflammatory disease, there is a growing concern among some clinicians about the need of adequate CV disease risk stratification to reduce the risk of CV events in patients with chronic inflammatory diseases.5
Poor control and management of CV risk factors among patients with chronic inflammatory diseases
Emmanuel et al also assessed the management of patients with chronic inflammatory disease in primary care centres.1 For this purpose, they compared results of patients with RA and IBD with those of matched controls. Their results indicate that CV disease risk assessment in patients with chronic inflammatory disease is poorly conducted in primary care centres.1 Studies conducted in rheumatology clinics indicate that the management of the classic CV risk factors by rheumatologists is even worse than the approach conducted by general practitioners. …
Contributors MAG-G and CG-J participated in the drafting of this editorial and take full responsibility for its content.
Funding MAG-G's research on cardiovascular disease in inflammatory arthritis is supported by grants from ‘Fondo de Investigación Sanitaria’ (PI06/0024, PS09/00748, PI12/00060 and PI15/00525) from ‘Instituto de Salud Carlos III’ (ISCIII, Health Ministry, Spain). It was also partially supported by RETICS Programs RD12/0009 (RIER) from ‘Instituto de Salud Carlos III’ (ISCIII, Health Ministry, Spain).
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.