Cardiovascular risk factors, including thrombotic variables, in a population with rheumatoid arthritis

Objective. To compare prevalent cardiovascular disease, conventional cardio vascular risk factors and thrombotic variables in a cohort with well-contro lled rheumatoid arthritis (RA) and in population controls. Methods. Seventy-six RA patients and 641 controls, randomly sampled from th e local population in the North Glasgow MONICA study. Conventional cardiova scular risk factors (blood pressure, smoking, cholesterol) and thrombotic v ariables [fibrinogen, von Willebrand factor (VWF), tissue plasminogen activ ator antigen (t-PA), fibrin D-dimer, plasminogen activator inhibitor (PAI-l ), plasma viscosity] were measured by standard procedures. Results. RA patients had a significantly higher prevalence of angina pector is (P = 0.03). Stroke also tended to be more common in the RA group, but th e difference did not reach statistical significance (P = 0.08). Diastolic b lood pressure was significantly higher and serum cholesterol significantly lower in the RA group than in controls. Current smoking habits and exercise history were similar in the two groups, although RA patients were more lik ely to have previously smoked. Significant elevations in several thrombotic predictors of cardiovascular disease (fibrinogen, VWF, t-PA antigen and fi brin D-dimer) were found in the RA group. Conclusions. In this RA patient population, diastolic blood pressure was hi gher than in controls and thrombotic variables were elevated compared with controls. These features are identified as potential additional cardiovascu lar risk factors in the RA patients studied. Prospective studies of risk mo dification may permit the identification of factors which could lead to a r eduction in the known increased cardiovascular risk in Re.