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Posted: November 04, 2008

Stiff Joints May Lead to Stiff Hearts: Arthritis, Heart Failure Linked

Researchers have uncovered new evidence that people with rheumatoid arthritis have an increased risk for heart failure and they may be on the track of understanding why, according to findings presented recently to health professionals and scientists.

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.


It’s known that people with RA are at increased risk for heart failure and death due to heart disease. What is less clear, however, are the factors that lead to heart failure in these patients, how to find it sooner, and how to possibly prevent it. Diastolic dysfunction is a condition in which the ventricles of the heart become relatively stiff leading to impaired filling. Over time, this can lead to heart failure.


Researchers recently compared the frequency of diastolic dysfunction in 149 people with RA to a group of 1,405 people without the disease. They conducted a community-based prospective study of adult patients with and without RA living in Olmsted County, Minnesota, who had no history of heart failure. Participants in both groups completed a questionnaire and had echocardiograms (cardiac ultrasounds), which were interpreted by the same study team to ensure comparability between participants.


Researchers found that diastolic dysfunction was more common in the patients with RA, occurring in 38.9%; compared to 28.8% in the non-RA group. They also found that patients in the RA group had higher average pulmonary arterial pressure, which is high blood pressure in the lungs and the right side of the heart.


“Wider use of echocardiography in patients with RA may reveal heart abnormalities before they are detected clinically,” explains Dr. Kimberly Liang, an assistant professor at the University of Pittsburgh in Pennsylvania and lead author of the study. “Early detection could improve long-term outcomes in these patients.”


The findings were presented at the American College of Rheumatology Annual Scientific Meeting in San Francisco. Although Liang is currently at the University of Pittsburgh, this research was done when she was at the Mayo Clinic in Minnesota.

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