Beyond Traditional Risk: Does Systemic Inflammation Drive Accelerated Atherosclerosis in Rheumatoid Arthritis?

Abstract

Cardiovascular disease (CVD) is the primary cause of morbidity and mortality in individuals with rheumatoid arthritis (RA) and other rheumatic diseases (RDs), contributing to an approximate 50% increased cardiovascular risk relative to the general population. In addition to conventional cardiovascular risk factors, disease-specific processes such as chronic inflammation, endothelial dysfunction, and immunological dysregulation substantially accelerate atherosclerosis. This thorough analysis brings together the most recent information on how to measure cardiovascular risk, how to understand the underlying causes of RA and other rheumatic diseases, and how to treat them all together. In RA, long-term inflammation throughout the body causes atherosclerosis through several different mechanisms that are not related to common risk factors. To lower the risk of heart disease, rheumatologists, cardiologists, dietitians, physiotherapists, and immunologists must all work together. Evidence supports the targeting of disease activity, the management of conventional cardiovascular risk factors such as hypertension, dyslipidemia, diabetes, and the use of non-pharmacological therapies.