Cardiovascular Morbidity and Mortality in Women Diagnosed With Rheumatoid Arthritis

DOI Web Site 6 Citations
  • Daniel H. Solomon
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.
  • Elizabeth W. Karlson
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.
  • Eric B. Rimm
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.
  • Carolyn C. Cannuscio
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.
  • Lisa A. Mandl
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.
  • JoAnn E. Manson
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.
  • Meir J. Stampfer
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.
  • Gary C. Curhan
    From the Division of Pharmacoepidemiology and Pharmacoeconomics (D.H.S.), Division of Rheumatology, Immunology, and Allergy (D.H.S., E.W.K., L.A.M.), and Division of Preventive Medicine, Channing Laboratory (J.E.M., M.J.S., G.C.C.); Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Department of Epidemiology (E.B.R., M.J.S., G.C.C.), Harvard School of Public Health, Boston, Mass; and Merck Research Laboratories (C.C.C.), West Point, Pa.

Description

<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> Rheumatoid arthritis may be associated with an increased risk of cardiovascular disease. We compared the incidence rates of myocardial infarction and stroke in subjects with and without rheumatoid arthritis. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> A prospective cohort study was conducted among the 114 342 women participating in the Nurses’ Health Study who were free of cardiovascular disease and rheumatoid arthritis at baseline in 1976. All self-reported cases of rheumatoid arthritis were confirmed by medical record review. Fatal and nonfatal myocardial infarctions and strokes were similarly confirmed. Multivariate pooled logistic regression was used to adjust for potential cardiovascular risk factors. Five hundred twenty-seven incident cases of rheumatoid arthritis and 3622 myocardial infarctions and strokes were confirmed during 2.4 million person-years of follow-up. The adjusted relative risk of myocardial infarction in women with rheumatoid arthritis compared with those without was 2.0 (95% confidence interval [CI], 1.23 to 3.29). For stroke, the adjusted relative risk was 1.48 (95% CI, 0.70 to 3.12). Women who had rheumatoid arthritis for at least 10 years had a risk for myocardial infarction of 3.10 (95% CI, 1.64 to 5.87). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusion—</jats:italic> </jats:bold> In this large prospective cohort of women, participants with rheumatoid arthritis had a significantly increased risk of myocardial infarction but not stroke compared with those without rheumatoid arthritis. If these data are confirmed, aggressive coronary heart disease prevention strategies should be tested for persons with rheumatoid arthritis. </jats:p>

Journal

  • Circulation

    Circulation 107 (9), 1303-1307, 2003-03-11

    Ovid Technologies (Wolters Kluwer Health)

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