MANAGEMENT OF CARDIOVASCULAR RISK FACTORS IN RHEUMATOID ARTHRITIS

Pacijenti s upalnim reumatskim bolestima, osobito s reumatoidnim artritisom (RA) imaju značajno povećani rizik za nastanak kardiovaskularnih (KV) bolesti u odnosu na opću populaciju. Ovo se osobito odnosi na povišeni rizik od infarkta miokarda i ishemijske bolesti srca. KV događaji i stope smrtnosti u RA veće su za 40-50 % u odnosu na opću populaciju, a rizik za ishemijsku bolest srca nešto je veći nego za moždani udar. Povećanje KV rizika u RA uzrokovano je kompleksnom sinergijom tradicionalnih i netradicionalnih faktora KV rizika, gdje upala izravnim ili neizravnim učincima na vaskularni sustav ima važnu ulogu i neovisni je čimbenik rizika. Pacijenti s jačom aktivnosti bolesti u RA imaju povećani rizik za razvoj srčanog zatajenja. Liječnici trebaju biti svjesni visokog KV rizika i osigurati dobar nadzor i liječenje KV bolesti u pacijenata s RA.Patients with infl ammatory rheumatic diseases, particularly rheumatoid arthritis (RA), have a signifi cantly increased risk of cardiovascular (CV) disease compared to the general population. This particularly refers to the increased risk of myocardial infarction and ischemic heart disease. CV events and mortality rate in RA are by 40%-50% higher as compared with general population and the risk of ischemic heart disease is slightly higher than that of stroke. The risk increase in RA is initiated by a complex interaction between traditional and non-traditional factors of CV risk, where infl ammation, through direct or indirect harmful effects on vascular system, plays an important role. The infl ammation in RA is crucial for the development of CV risk and is an independent risk factor for the increased incidence of CV diseases. Patients having stronger disease activity in RA have an increased risk of developing heart failure. Doctors of medicine should be aware of the high CV risk and provide good control and treatment of CV diseases in RA patients