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Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in patients with inflammatory rheumatic diseases, notably systemic lupus erythematosus and rheumatoid arthritis. The pathophysiology of premature and accelerated atherosclerosis in those patients is multifactorial, involving traditional cardiovascular risk factors, systemic and vascular chronic inflammation and adverse effects of drugs, such as corticosteroids and non-steroidal anti-inflammatory drugs. Considering the premature and accelerated atherosclerosis in chronic rheumatic disease, guidelines for the management of rheumatic inflammatory disorders recommended that patients should be screened for CVD, with aggressive management of traditional cardiovascular risk factors to try to reduce this excess vascular risk.1
Polymyalgia rheumatica (PMR), characterised by bilateral aching and stiffness of the extremities girdle, is the most common inflammatory rheumatic disease of the elderly.2 Giant cell arteritis (GCA) is a large-vessel vasculitis that involves the major branches of the aorta with predilection for the extracranial branches of the carotid artery, including temporal arteries.3 PMR and GCA are closely related and overlapping inflammatory syndromes occurring in individuals aged 50 or older, with incidence continuously increasing with ageing. The estimated prevalence of PMR and GCA are, respectively, 1:200 and 1:750 persons older than 50 years.2 ,3 The highest annual incidence rates of PMR were observed in Northern Europe, 50–100 per 100 000 population older than 50 years, while, for GCA, age-specific incidence rates per 100 000 population increase from 2 in the age group 50–59 years to 52 in the age group 80 years and older.2 ,3
Some controversy exists regarding the association between PMR and GCA and CVD. A systematic review concluded …
Contributors Both authors wrote and reviewed the current text.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.