Rheumatoid Arthritis: The Heart of the Matter

Heart disease risk may increase in rheumatoid arthritis patients with depressive symptoms

Rheumatoid arthritis and heart disease often go hand-in-hand. Now researchers may have found at least one reason why that is.

A new study from Columbia University found that emotional symptoms and lack of social support may increase heart disease risk in rheumatoid arthritis (RA) patients.

This may be because patients with symptoms of depression, anxiety, stress and anger tend to develop more plaque (fatty deposits in the arteries), which contributes to heart disease.

"Understanding the risk factors that lead to greater mortality in those with chronic conditions like RA is extremely important," said lead study author Jon Giles, MD, MPH, an assistant professor of medicine at Columbia, in a press release. "Our study is the first to investigate the association between psychosocial comorbidities [conditions that coexist with RA] and elevated risk of atherosclerosis in RA patients."

RA is an autoimmune disease in which the body attacks its own cells. Patients with RA develop fatigue and joint pain, swelling and stiffness.

Heart disease is known to occur more frequently in RA patients than in those who don’t have the condition.

The reasons for this increased risk are still unknown.

Dr. Giles and team used data from an ongoing study called the Evaluation of Subclinical Cardiovascular Disease and Predictors of Events in Rheumatoid Arthritis Study (ESCAPE) to look at 195 RA patients and 1,073 patients without RA.

All patients underwent testing to evaluate the level of calcium in their heart arteries and check for plaque buildup.

The patients with RA who had higher scores for depression, anger and anxiety had higher levels of calcium.

High calcium in the heart arteries is a predictor of heart disease.

RA patients who reported higher levels of job stress also had an increased risk of plaque.

Patients with higher levels of social support had less plaque.

This study was published in the August issue of the journal Arthritis Care & Research.

The Rheumatology Research Foundation funded this research. No conflicts of interest were disclosed.