Arterial Stiffness in Rheumatoid Arthritis Patients: Do Disease Activity and Duration of Illness Matter?

• Main Authors: Awalia, Satyadi, Sony Wibisono, Joewono Soeroso
• Format: Conference or Workshop Item PeerReviewed
• Language: English; English
• Published: 2019
• Subjects: R Medicine (General); RC Internal medicine
• Online Access: http://repository.unair.ac.id/108985/1/C-46.pdf; http://repository.unair.ac.id/108985/2/C-46%20KADEP.pdf; http://repository.unair.ac.id/108985/; https://ard.bmj.com/content/annrheumdis/78/Suppl_2/1608.2.full.pdf
• Institution: Universitas Airlangga

Background: Recent evidence has demonstrated that the increased risk of mortality in rheumatoid arthritis (RA) patients is largely related to cardiovascular disease (CVD). Overall, RA increases the risk of cardiovascular (CV) mortality by up to 50% for reasons which are insufficiently understood. Chronic inflammation may impair vascular function and lead to increase of arterial stiffness. Measurement of arterial stiffness provide an independent risk factor of CV mortality and morbidity. Brachial pulse-wave velocity (BPWV) is a reproducible method to estimate of arterial stiffness. Whether the disease activity or duration of illness has more contribution in arterial stiffness of RA patients is still controversial. Objectives: To investigate the correlation of disease activity and duration of illness in RA patients with pulse-wave velocity as a measure of arterial stiffness, free of cardiovascular disease and risk factors. Methods: RA patients aged 55 years-old or younger were screened for the absence of clinical cardiovascular disease or risk factors (diabetes mellitus, dyslipidemia, hypertension, chronic kidney disease, smoking, obesity, cancer, prolong infections, excessive steroid use, or other inflammatory diseases). Patients were subjected to full history taking, clinical examination, and laboratory investigations including serum lipid profile, CRP, and ESR. Then they were recorded for their brachial pulse-wave velocity using PWV Sphygmograph. Results: There were 30 suitable patients (all were female, mean age was 44.17 ± 7.98 years-old, mean duration of illness was 1.88 ± 0.94 years). Average systolic blood pressure was 121.67 ± 7.46 mmHg, mean diastolic pressure was 74.00 ± 4.98 mmHg. Average body mass index was 22.43 ± 1.18. Mean DAS28-ESR was 3.29 ± 1.32, and mean DAS28-CRP was 3.30 ± 4.02. Average of BPWV was 14.44 ± 3.86 m/s. This study did not show any correlation between duration of illness and arterial stiffness (p=0.832). But it revealed moderate correlation between disease activity (either DAS28-ESR or DAS28-CRP) with arterial stiffness (r=0.441 with p=0.015 and r=0.501 with p=0.005). Conclusion: This preliminary suggests that disease activity of RA is correlated with arterial stiifness free of cardiovascular disease or risk factors. But duration of illnes does not show any correlation with arterial stiffness as believed before, it may need more sample size to determine that. This findings support the importance of inflammation control in RA patients not just to improve quality of life but also to decrease cardiovascular mortality in RA.