Discovery’s Edge: The rheumatoid arthritis and heart disease connection

Physicians have long known that people with rheumatoid arthritis and other rheumatic conditions such as lupus are more likely to die at younger ages than are those without these conditions. Even with advances in treatment, the gap in life expectancy remains.

No one knew why until 15 years ago. That’s when researchers at Mayo Clinic helped establish that people with rheumatoid arthritis have a greater chance of developing various types of cardiovascular disease.

“We now know that rheumatoid arthritis is associated with an increased risk of heart and vascular disease,” says senior researcher Sherine E. Gabriel, M.D., a rheumatologist and epidemiologist previously in the Department of Health Sciences Research at Mayo Clinic’s campus in Rochester, Minnesota. “What is less understood is why people with rheumatoid arthritis develop that increased risk.”

The evidence increasingly points to inflammation as a major contributor to that increased risk of cardiovascular disease.

In rheumatoid arthritis, the immune system attacks the synovium — the lining of the membranes around the joints. The resulting inflammation thickens the synovium, which can, in turn, eventually destroy cartilage and bone in the joint.

Inflammation can also cause the inner linings of arteries to swell. This narrows the arteries, raises blood pressure, and reduces blood flow to the heart and other organs.
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