Hi guys I was reading this yesterday and just wondered what your thoughts are? Have your Dr's spoke to you about this because mine hasn't and just wondered if we should be asking for more regular tests and check ups?
Something else to worry about!!! Hope this link works!!
Yes it worked!! I'm fully aware & have been from my first Consultation 7 years ago when family history was discussed. My risk is increased as both my mum & dad had heart issues & my mum died waiting for reparative op at age 61. Thankfully I'm well monitored & all that has been found is raised cholesterol for an higher risk group & as a result take statins. I have a cholesterol check at the next round of drug monitoring bloods, mine are done half yearly until at an acceptable level.
i always wonder about raised cholesterol - doctors seem to want to treat it as a separate entity with statins, but I believe one of the big causes of raised cholesterol is inflammation. So is it a case of if your RA inflammation isn't treated properly, then you may end with higher than normal cholesterol, and that may lead to heart problems?
I know my borderline high cholesterol always goes into the normal range when I am taking adequate antiinflammatory meds, and always goes up when I am not on antiinflammatory treatment.
I can't speak for everyone but my inflammation is under control, or rather has been generally but it was found in my toes when my Rheumy eventually relented & examined them. MTX was increased & it seems to have worked in all but my ankle joints which have been swollen for a long time. Everywhere else is under control thankfully, ESR 7 & CRP 2. My personal marker is my hands, my fingers don't swell at all unless my meds need adjusting or if I need to stop the MTX but they let me down this last time! I have a comprehensive CV check as I've been taking etoricoxib for about 4 years & all is well except for raised cholesterol for higher risk group as I mentioned above & will continue to have lipids test until I reach an acceptable level. Three months of trying to reduce it by diet alone didn't work at bringing my LDL down (with absolutely no cheating!) so I have no alternative but to take statins.
My rheumy asked my GP to test & monitor my cholesterol from the start (the monitoring was because it was high at first but then okay - which might fit with what earthwitch says I guess). He questioned me re. possible symptoms of heart disease and listens to my heart at every appointment.
I think it is fairly well known that inflammatory diseases can contribute to heart disease. That's another reason for getting it RD under control ASAP.
I am a tad suspicious of the whole cholesterol bandwagon and of 'low-fat' diets but that's another story!
I spent two days in coronary care unit after chest pain while at the cinema - scared my poor friend! I was impressed with the care that I received and it turned out to be GERD. The cardiologist was wonderful, he explained that acid reflux can cause a spasm in the oesophagus that exactly causes all the symptoms of a heart attack and he confirmed I had acted wisely by attending A&E. He confessed that he had attended A&E with exactly the same symptoms and it turned out to be GERD as well. I was really impressed that he had shared that with me and to allay my anxiety that I had wasted everybody's time. Downside was MRI scan showed normal age related furring off the arteries and was prescribed a statin. I have not started the statin because side effects are gastro intestinal and more acid reflux. Cardiologist did say it was a preventative treatment looking at the long term, but as acid reflux caused my admission in the first place it did not make sense to take them and suffer more reflux (ironic really).
The potential for heart problems does scare me. I am menopausal so heart attack increases post menopause and now the fact that RA is also a risk factor is worrying. Two DMARDs that I was on caused a fast heartbeat which settled down when I stopped the drugs, however pulse dropped to 62 which is too much the opposite way. I've now started MTX injections and pulse rate is starting to race again. It could be argued that it's the inflammatory process causing rapid heart beat and not necessarily the drugs. Regardless of where the truth lies, it can not be good for the heart to be switching between being slow and then too fast. I hope someone somewhere is researching this. I will certainly be keeping a check on this and raising this with GP/Rheumy. It would be interesting to hear if anyone else is having heart rate issues?
Hi, I have had a rapid heartbeat for several years before I taking RA meds. I also take thyroxin meds and they also give you a rapid heartbeat. I am on the gp system as a high risk patient due to having RA. I am also monitored closely at my gp/rheumy clincs with regular blood tests.
There was an Australian study which showed an increase in Atrial Fibrillation with RA. It stand to reason general inflammation can cause problems in other parts of your body. Be aware of your body and any changes you feel.
I was told from the start that RA increases risks of heart problems, and BP, weight & cholesterol are checked regularly. I was also advised to loose weight and take regular exercise (and not smoke which I didn't anyway). It's also why rheumies are often very careful with NSAIDS with us. Since I followed the advice, overall I'm in better shape now than I was pre-RA so have stopped worrying overmuch.
But if you look at the details of that study it was only 91 people, and a lot of them smoked, had high cholesterol (fat In blood), diabètes and/or high BP. So it wasn't that groundbreaking a study, and the newspaper is using usual shock tactics to sell their paper. As far as I'm concerned you do what you can to look after yourself properly, and then try not to worry as stress isn't good for you either!
It's not a published study as yet, but based on a paper given at a conference in Madrid last week.
Dr Puente concluded: "Patients with rheumatoid arthritis should be told that they have an elevated predisposition to heart disease and need pharmacological treatment to diminish the inflammatory process and atherosclerotic complications. They also need advice on how best to control their rheumatoid arthritis and decrease their cardiovascular risk factors. Patients who take corticosteroids and methotrexate for their rheumatoid arthritis are susceptible to elevated plasma lipid levels and develop hyperhomocysteinemia, respectively, which are both cardiovascular risk factors and require preventative treatment."
I understood that, so was trying to make clear that it seems not to have got to that stage yet, but maybe once congress papers are published. I haven't yet done a search for research already punished by that team.
Totally agree with your second paragraph Helixhelix, as usual the tabloid press are using scare tactics to sell their papers. My own doctor here in Spain advised me right from the start not to search RA on the internet (must admit I ignored that though) and read newspapers. As you say, we must all try to help ourselves as much as we can, ie no smoking, sensible diet etc, hopefully our doctors will do the rest to help our condition. Take care.
Thanks helixhelix for looking at the original study!
The sensational reporting that the Mail always goes in for alarms people without informing them sufficiently.
The increased risk of heart disease is well known and can be lowered by good control. I am also suspicious of the emphasis on "prevention" by taking statins especially in women where the research results are much less certain.
Stopping smoking in those who indulge is probably the most important.
Control of weight is, of course, difficult when we are limited in the amount and type of exercise we can take, but not impossible.
The Scottish NHS requires GPs to complete a formal heart disease risk assessment tool for all newly diagnosed RD patients. It factors in weight, BP, smoking, family history, cholesterol & social deprivation. The score puts you into a risk category for developing CHD in the next 10 years, which dictates how often the assessment is redone & any further action to be taken.
At last we seem to be doing something about our awful record on heart disease.
Yes I was told about this increased risk as well although apparently it is possible that the risk is reducing with the disease being better managed in severe cases with biologic drugs.
Although I can't find anything on this study on the site at the moment, I find checking the NHS Choices website - Behind the Headlines - is always helpful to help understand the facts related to what we read in the papers. See nhs.uk/News/Pages/NewsIndex...
Can someone write a brief summary? I have Kittenblock on my computer so I don't accidentally go to the Mail website, and I'm not disabling it for anything! Cheers.
It's important to be aware of the cardiovascular risk in patients with RA, which is highlighted in yesterday's Daily Mail article.
A study in Mexico City, showed that one quarter of patients with rheumatoid arthritis and no symptoms of heart disease could have a heart attack without prior warning.
Screening for CVD risk in the general population is normally the remit of GPs and there are well known procedures used to measure known risk factors such as high blood pressure, raised cholesterol, diabetes and obesity. If you haven't been assessed, do ask about this at your next appointment.
Find out more about cardiovascular risk and RA on our website at nras.org.uk/cardiovascular-... or do give our Helpline a ring on 0800 298 7650 if you have any questions or concerns.
Interesting comments about cholesterol and inflammation. I'm 27 and mine has hovered between 7 and 9 (very high!) for a few years. I was clinically obese, have lost 4 stone and the numbers keep falling and my diet is excellent but my cholesterol is worryingly high. My GP surgery are on the ball; check cholesterol and blood pressure 2x a year and ECG yearly.
I believe some of the medications we take can be also linked to heart disease.
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