Results from systematic screening for cardiovascular risk in outpatients with rheumatoid arthritis in accordance with the EULAR recommendations

Aim To investigate risk factors for the development of cardiovascular disease (CVD) and estimate the risk of cardiovascular death in rheumatoid arthritis (RA) patients in accordance with EULAR recommendations. Materials and methods Outpatients with RA 85years of age from a Danish hospital were invited to participate. Patients' risk of cardiovascular death was calculated according to the SCORE system, based on total cholesterol/high-density lipoprotein (HDL) ratio, smoking habits, blood pressure, age and gender. The SCORE was adjusted based on disease duration, IgM-RF/anti-CCP positivity and the presence of extra-articular manifestations. Factors such as history of CVD, hypertension or diabetes mellitus (DM), fasting glucose, exercise habits, body mass index (BMI) and waist circumference were explored. Results 836 patients participated; 71.5% women; mean (SD) age 64.3years (12.0); 152 (19.1%) were already diagnosed with CVD and 74 (9.0%) with DM. Among the 644 patients without CVD or DM, 158 (24.5%) were smokers, 229 (35.8%) had a systolic blood pressure 140, 397 (65.6%) total cholesterol 5.0mM/L, 326 (55.4%) low-density lipoprotein cholesterol 3.0mM/L, 18 (4.0%) women and 19 (12.1%) men had a HDL-cholesterol level below 1.2/1.0mM/L. BMI was >25 in 409 (63.8%). Waist circumference was above 80/94cm in 297 (63.3%) of female and 111 (63.8%) of male patients, respectively, and 418 (64.9%) exercised 5 times a week. Among patients without DM, 14.3% had a fasting glucose 6.0mmol/L. The SCORE was 5 in 122 (20.2%). They were referred to follow-up by their GP and community advice services. Conclusions Systematic screening revealed several risk factors that needed medical follow-up or support to initiate lifestyle changes.