Cardiovascular risk in patients with inflammatory arthritis

D. A. Anichkov, N. Shostak, V. T. Timofeev
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Abstract

Rheumatoid and other inflammatory arthritis (ankylosing spondylitis and psoriatic arthritis) have a high risk of cardiovascular disease (CVD). It is caused by the accelerated development of atherosclerosis associated with a chronic systemic inflammatory process. Nevertheless, traditional CVD risk factors (hypertension, smoking, dyslipidemia) are also important for patients with inflammatory arthritis. The greatest amount of data has been accumulated regarding the relationship between CVD and rheumatoid arthritis. Due to the difficulties in diagnosing coronary heart disease and other CVD, it is of great importance to identify patients at high and very high risk. The use of scales for assessing the total cardiovascular risk SCORE/SCORE 2 with a coefficient of 1.5 allows to identify patients who need measures to reduce their high risk of CVD. Control of the of the disease activity, lifestyle modification, therapy with statins and antihypertensive drugs in accordance with current guidelines, caution when prescribing non-steroidal anti-inflammatory drugs and minimizing the dose of glucocorticoids are the main components of the strategy for reducing the risk of CVD in patients with inflammatory arthritis.
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炎症性关节炎患者的心血管风险
类风湿关节炎和其他炎症性关节炎(强直性脊柱炎和银屑病关节炎)罹患心血管疾病(CVD)的风险很高。这是由于与慢性全身性炎症过程相关的动脉粥样硬化加速发展所致。然而,传统的心血管疾病风险因素(高血压、吸烟、血脂异常)对炎症性关节炎患者也很重要。有关心血管疾病与类风湿性关节炎之间关系的数据积累最多。由于冠心病和其他心血管疾病的诊断非常困难,因此识别高风险和极高风险患者非常重要。使用系数为 1.5 的心血管总风险评估量表 SCORE/SCORE 2,可以识别出需要采取措施降低心血管疾病高风险的患者。根据现行指南控制疾病活动、改变生活方式、使用他汀类药物和降压药物治疗、谨慎使用非甾体类抗炎药物以及尽量减少糖皮质激素的剂量,这些都是降低炎症性关节炎患者心血管疾病风险策略的主要组成部分。
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