Is there a link between arthritis and heart disease?

Inflammation is a risk factor for heart disease, so inflammatory conditions like rheumatoid arthritis (RA), gout, lupus and psoriatic arthritis can increase your risk.

Inflammatory cells get into blood vessel walls where they make cytokines – immune system proteins that promote inflammation. Inflammation can also reshape blood-vessel walls, making deposited plaques more prone to rupture. A rupture can trigger a heart attack.

The risk isn’t limited to people with inflammatory arthritis. Damage from osteoarthritis (OA) – a disease of the whole joint that leads to the breakdown of joint cartilage and the underlying bone – can cause inflammation, which in turn increases the risk of heart disease.

  • People with RA face a 50 percent higher risk for cardiovascular disease and are significantly more likely to have a heart attack or be hospitalized for heart failure.
  • People with OA face a 24 percent higher risk for cardiovascular disease than the general population.
  • Nearly half of all adults with heart disease also have arthritis.
  • Nearly 60% of people with arthritis are women.
  • 1 in 4 Canadian women and 1 in 6 Canadian men have arthritis.
  • While arthritis affects people of all ages, the likelihood increases with age.

WHAT CAN BE DONE TO REDUCE RISK?

Having arthritis doesn’t necessarily mean you will develop heart disease. However, there are certain risk factors for arthritis and heart disease that overlap, like obesity, high blood pressure, smoking, diabetes, and high cholesterol. You can mitigate your risk by reducing these lifestyle risk factors through exercise, not smoking, a healthy diet, a healthy body weight, and keeping your diabetes under control.

It’s also important to manage your arthritis to ensure you have the lowest amount of systemic inflammation possible. A large study in the 2017 Annals of the Rheumatic Diseases found that people with RA who had their disease well-controlled were less likely to develop cardiovascular disease.

Arthritis can be managed with medication, although the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is not recommended as they can increase the risk of heart attack or stroke. While exercise can also help manage arthritis, joint pain can make it difficult, especially for those with OA who are overweight or obese.

Image-guided pain therapy injections may be an option to improve pain, function, and stiffness in patients with mild to moderate OA. Osteoarthritis is a chronic (long-term) disease and, although there is no cure, new guidelines suggest earlier treatment and management may slow the disease. Earlier treatment will reduce your symptoms and make it possible for you to lead a full and active life. It’s important to thoroughly discuss all your options with your health care practitioner.

For more information on image-guided pain therapy injections, please speak to your health care practitioner.


REFERENCES

Agca, R., et al. (2017) “EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update.” Annals of the Rheumatic Diseases. 2017; 76:17-28. Accessed February 21, 2020.

Arthritis Foundation (2018) “Arthritis and Heart Disease.” www.arthritis.org. Accessed February 21, 2020.

Arthritis Society & Dr. J. Hochman. (2017) "Osteoarthritis." www.arthritis.ca. Accessed February 21, 2020.

Arthroscopy Association of Canada (2019) “Arthroscopy Association of Canada Position Statement on Intra-articular Injections for Knee Osteoarthritis.” Orthopaedic Journal of Sports Medicine. 7 (7). Accessed February 21, 2020.

Eder, L. & Harvey, P. (2018) “Inflammatory diseases can increase risk of heart disease: Doctors’ Notes.” www.thestar.com. Accessed February 21, 2020.

Osteoarthritis Research Society International (2019) “OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.” Osteoarthritis Cartilage. Nov; 27(11):1578-1589. Accessed February 21, 2020.

Healthy Living, Symptoms