Learn how having arthritis can affect heart health and what you can do to protect yourself.
Introduction:
Arthritis may increase your risk of developing heart disease.
Rheumatoid Arthritis (RA), Gout, Lupus, Scleroderma, Sjögren’s Syndrome and Psoriatic Arthritis are particularly significant risk factors for heart disease. These can include heart attack, stroke, atrial fibrillation (irregular heartbeat), high blood pressure, and heart failure, and atherosclerosis (plaque in the arteries).
Chronic inflammation and your heart:
Inflammatory arthritis is sometimes called ‘auto-immune arthritis’, ‘auto-inflammatory arthritis’, and used to be called ‘rheumatism’. In autoimmune diseases, the body sends wrong messages to immune cells, such as white blood cells, instructing them to attack the body’s own tissues.
These conditions are very complex and are the result of our immune system malfunctioning, causing our body to attack itself. Often, our body will mistakenly send large amounts of inflammation to our joints.
This inflammation then starts to attack the healthy parts of our joints causing them to become swollen and painful. Inflammatory forms of arthritis are systemic conditions, meaning if they are left untreated, they may spread around the body causing inflammation in other joints and organs.
Rheumatoid arthritis (RA):
RA is one of the most common types of inflammatory arthritis and has the most research into its relationships with heart disease. People with RA are 50-70% more likely to develop heart disease than the general population.
Patients with RA may develop inflammation in the heart muscles, especially during disease flares. This can often be symptomless. Chronic inflammation from RA can damage the blood vessels and may cause plaque to build in the arteries. This plaque can narrow the blood vessels and block blood flow, leading to heart attack or stroke.
Patients with inflammatory joint diseases may have arrhythmias (irregular heartbeat). Other forms of inflammatory arthritis, such as lupus, Sjögren’s syndrome, scleroderma, inflammatory myositis, and psoriatic arthritis can also be linked with chronic inflammation in various body systems.
This chronic inflammation can be typically seen in the joints, eyes, skin, lungs, and kidneys, but also in the heart and vascular system.
Lifestyle Behaviours and Your Heart:
Having arthritis does not mean you will get heart disease. Obesity, high blood pressure, diabetes, and high cholesterol are all risk factors for heart disease. These factors may overlap in arthritis patients.
Another major lifestyle risk factor for heart disease is smoking. It raises blood pressure, lowers HDL (good cholesterol), and accelerates plaque build-up in arteries.
Healthy diet and exercise can help us to maintain a health weight, manage blood pressure and cholesterol levels, and conditions like diabetes. However, exercise can be challenging for some people with arthritis as it is difficult to exercise when you are in pain.
The best way to overcome the barrier that prevents you from exercising is to find a fitness program that suits your abilities, seek advice from your doctor, and start slowly.
Also, aerobic and resistance exercise training for arthritis patients is effective in improving overall wellbeing, the muscle mass loss associated with arthritis, and significantly improving physical function without worsening disease activity. It is likely to reduce cardiovascular risk and should be part of a healthy lifestyle.
How arthritis drugs can be beneficial for your heart:
Medication is one of the most effective ways to manage arthritis and related health problems. Disease-modifying anti-rheumatic drugs (DMARDs) reduce joint pain and may protect the heart by reducing inflammation.
Whether that’s methotrexate, a biologic, or another medication your rheumatologist has prescribed, DMARDs may also help protect your heart.
Methotrexate, the first-line treatment for RA, has been associated with a lower cardiovascular risk, with evidence indicating a 21% reduction in cardiovascular events.
DMARDs aid in the control of RA inflammation while it may also lower the risk of heart attack, stroke, and other cardiovascular events.
For more information, read our free infosheet on Medicines and Arthritis.
August 2022