Polymyalgia rheumatica and cardiovascular disease

[Ozark]

Does anyone in this group have any information pertaining to the relationship between PMR and cardiovascular disease? Those of us that have this disease are in a chronic state of inflammation and to the best of my knowledge this would tend to increase to whatever degree the possibility of increased cardiovascular risk. So has anyone done any research on this and does anyone have any hard numbers concerning this?

[Joydeck]

"Patients with polymyalgia rheumatica (PMR) are at 2.5 times the risk for a vascular event than matched control patients, with the greatest risk occurring in patients younger than 60 years", according to a study published online 28 July 2014 in CMAJ.

Perhaps it's the disabilities PMR brings rather than PMR per se.

[PMRpro Ambassador]

ncbi.nlm.nih.gov/pmc/articl...

They do mention claudication and ischaemic symptoms - both of which can be signs of GCA and, as they point out, there is no definitive test for PMR. I have had thigh and jaw claudication in the early pre-pred stages of PMR and the consensus is it was probably due to LVV (large vessel vasculitis) and there is no way of knowing if that is GCA in particular. So there does have to be a question as to whether some of the PMR cases were really GCA without cranial symptoms. If you see what I'm getting at.

It is one of the things I often say - it isn't a case of pred bad, no pred good. Unmanaged inflammation is causing damage in the background even if we can't feel or see it.

[YuliK in reply to PMRpro]

Wow that's quite an interesting article

PMR/pro, thank you.

(35 page) Alternatively, the excess risk in polymyalgia rheumatica may be mediated by corticosteroids, via adverse effects on blood pressure and lipids. Study results suggest that prednisolone is associated with increased cardiovascular events at doses higher than 7.5 mg/d,15 although other studies of steroid use in polymyalgia rheumatica36 and rheumatoid arthritis 37 did not find an association between steroid dose and vascular risk, suggesting there may be a trade-off between adverse events of steroids on blood pressure and lipids and their efficacy in controlling inflammation.

This above paragraph was very interesting indeed. Trade off, would that mean there is actually no evidence either way 🙏