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Cardiovascular Medicine
Volume 18
Issue 4
10.4414/cvm.2015.00307
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Cardiovascular Medicine is published by MDPI from Volume 28 Issue 1 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Editores Medicorum Helveticorum (EMH).
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Review

Cardiovascular Risk Management in Patients with Rheumatoid Arthritis

by
Cem Gabay
1,
Nicolas Buchs
2,
Jean Dudler
3,
Paul Hasler
4,
Baris Gencer
5,
Christian Matter
6,
Beat Michel
7,
Johannes von Kempis
8,
Pascal Zufferey
9 and
François Mach
5,*
1
Division of Rheumatology, University Hospitals of Geneva, 1205 Geneva, Switzerland
2
Private Practice, Geneva, Switzerland
3
Division of Rheumatology, HFR Fribourg – Hôpital Cantonal, Fribourg, Switzerland
4
Division of Rheumatology, Cantonal Hospital Aarau, 5001 Aarau, Switzerland
5
Division of Cardiology, University Hospitals of Geneva, 1205 Geneva, Switzerland
6
Division of Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland
7
Division of Rheumatology, University Hospital Zurich, 8091 Zurich, Switzerland
8
Division of Rheumatology, Cantonal Hospital St. Gallen, 9000 St. Gallen, Switzerland
9
Division of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1015 Lausanne, Switzerland
*
Author to whom correspondence should be addressed.
Cardiovasc. Med. 2015, 18(4), 127; https://doi.org/10.4414/cvm.2015.00307
Submission received: 22 January 2015 / Revised: 22 February 2015 / Accepted: 22 March 2015 / Published: 22 April 2015
Versions Notes

Abstract

Cardiovascular diseases (CVD) and complications occur prematurely and approximately 1.5 times more frequently in patients with rheumatoid arthritis (RA) compared to the general population. The higher level of CV complications is insufficiently explained by the traditional cardiovascular (CV) risk factors. There is substantial evidence that chronic systemic inflammation contributes to excess CVD in RA and that effective suppression of RA-associated inflammation reduces CV morbidity. CV risk assessment and management tools were developed many years ago for the general population. A Swiss expert group consisting of cardiologists and rheumatologists has elaborated the following pragmatic guidelines for the management of CV risk in patients with RA. In addition to systematic screening for and reduction of traditional individual CV risk factors based on the national risk score model, the direct link between inflammation and the development of atherosclerosis demands early and effective control of joint and systemic inflammation. Antirheumatic therapy preferably includes methotrexate, a disease modifying antirheumatic drug (DMARD) and, if necessary, tumour necrosis factor-α blockers or other biologics, because they are not only effective in the treatment of RA but might also reduce excess CV events in patients with RA. Additional treatment should be initiated according to the strategies for lowering circulating lipids and blood pressure as published by the European Society of Cardiology and European Atherosclerosis Society. Pharmacological interventions should be complemented by lifestyle changes.
Keywords: cardiovascular risk; rheumatoid arthritis; disease modifying antirheumatic drug; DMARD cardiovascular risk; rheumatoid arthritis; disease modifying antirheumatic drug; DMARD

Share and Cite

MDPI and ACS Style

Gabay, C.; Buchs, N.; Dudler, J.; Hasler, P.; Gencer, B.; Matter, C.; Michel, B.; von Kempis, J.; Zufferey, P.; Mach, F. Cardiovascular Risk Management in Patients with Rheumatoid Arthritis. Cardiovasc. Med. 2015, 18, 127. https://doi.org/10.4414/cvm.2015.00307

AMA Style

Gabay C, Buchs N, Dudler J, Hasler P, Gencer B, Matter C, Michel B, von Kempis J, Zufferey P, Mach F. Cardiovascular Risk Management in Patients with Rheumatoid Arthritis. Cardiovascular Medicine. 2015; 18(4):127. https://doi.org/10.4414/cvm.2015.00307

Chicago/Turabian Style

Gabay, Cem, Nicolas Buchs, Jean Dudler, Paul Hasler, Baris Gencer, Christian Matter, Beat Michel, Johannes von Kempis, Pascal Zufferey, and François Mach. 2015. "Cardiovascular Risk Management in Patients with Rheumatoid Arthritis" Cardiovascular Medicine 18, no. 4: 127. https://doi.org/10.4414/cvm.2015.00307

APA Style

Gabay, C., Buchs, N., Dudler, J., Hasler, P., Gencer, B., Matter, C., Michel, B., von Kempis, J., Zufferey, P., & Mach, F. (2015). Cardiovascular Risk Management in Patients with Rheumatoid Arthritis. Cardiovascular Medicine, 18(4), 127. https://doi.org/10.4414/cvm.2015.00307

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