Arteriosclerosis and RA

-Tokyo Arthritis Clinic-

Rheumatoid arthritis and aging of blood vessels

Did you know that patients with rheumatoid arthritis are more likely to develop arteriosclerosis?

Studies have shown that while the lifespan of people with rheumatic diseases has increased dramatically due to advances in treatment, the risk of developing arteriosclerosis is comparable to that of the general population aged 10 years.

In other words, if you have RA, your blood vessel age is 10 years older than that of a healthy person.

In fact, RA is not just a joint disease.

Inflammation of blood vessels throughout the body. Therefore, if RA is not controlled, systemic arteriosclerosis is likely to progress.

One in four Japanese die of myocardial infarction or stroke.

Arteriosclerosis has come to be considered an important complication that affects the lifespan of people with rheumatic diseases.

How Much Does Rheumatoid Arteriosclerosis Advance?

Arteriosclerosis includes invariable factors such as aging and men, as well as smoking, lack of exercise, high blood pressure, dyslipidemia (high triglyceride and LDL cholesterol levels, low HDL cholesterol levels), diabetes and obesity (especially). The combination of risk factors such as visceral fat obesity makes it easier to progress.

In people with rheumatoid arthritis and other rheumatoid arthritis, in addition to the general risk factors mentioned above, inflammation and genetic predisposition are also known to be important factors in promoting arteriosclerosis. Rheumatoid arthritis is 1.5-2 times more likely to develop arteriosclerosis , which is as high as type 2 diabetes, which is known as a major risk factor.

Two points to prevent aging of blood vessels in patients with RA

  1. Suppressing inflammation in rheumatoid arthritis and controlling disease activity

    It is very important to prevent the progression of arteriosclerosis and the onset of arteriosclerosis. Methotrexate and TNF inhibitors (biopharmacy) used to treat rheumatoid arthritis have been reported to reduce the risk of developing arteriosclerosis by about 30%.

    The minimum use of steroids is recommended because it suppresses inflammation and works in a positive direction for arteriosclerosis, but it may also increase conventional risk factors such as lipid / glucose metabolism and blood pressure. At our hospital, we are proposing treatments that can reduce the amount and duration of oral administration by successfully incorporating steroid joint injections.

  2. Control of lifestyle-related diseases

    At the same time, it is important to actively evaluate and control common risk factors. Lifestyle changes such as smoking cessation, exercise, diet, and weight management can help prevent the progression of arteriosclerosis. It is useful to monitor lipids (neutral fat, LDL cholesterol and HDL cholesterol levels), blood glucose / HbA1 etc. by blood pressure measurement and blood test, and also perform drug therapy if arteriosclerosis risk factors do not improve for several months. is. Arteriosclerosis progresses unnoticed. Try to prevent the development of life-threatening arteriosclerotic lesions.

What is the proper amount of steroids
that does not accelerate aging of blood vessels ?

Care should be taken when long-term use above PSL 7.5-10mg, depending on the underlying disorder, as it may affect classical cardiovascular risk factors. For rheumatoid arthritis, we will focus on anti-rheumatic drugs such as MTX and biopharmacy, and always aim to reduce the dose of steroids (the first goal is 5mg or less) and discontinue .