Article

Rheumatoid arthritis is associated with increased cardiovascular
morbidity and mortality.
We performed a systematic review of the literature and a
meta-analysis to look for differences in the prevalence of traditional
cardiovascular risk factor between RA patients and controls. METHODS: Medline
database was searched to identify studies evaluating the prevalence of
traditional cardiovascular risk factors in rheumatoid arthritis patients and
controls. Studies were selected and reviewed by two investigators. Odds ratios
(ORs) and 95% confidence intervals (95% CIs) were calculated and pooled using a
random-effects model. Statistical heterogeneity was evaluated through the use of
Chi2 and I2 statistics. RESULTS: Fifteen case-control studies with a total of
2956 patients and 3713 controls met the inclusion criteria. The prevalence of
smoking was increased in RA patients in comparison with controls: OR (95%CI) 1.56
(1.35-1.80) (P < 0.00001). The prevalence of hypertension did not differ: OR (95%
CI) 1.09 (0.91-1.31) (P = 0.35). The prevalence of diabetes mellitus was
increased in RA: OR (95%CI) 1.74 (1.22-2.50) (P = 0.003). The prevalence of
hypercholesterolemia did not differ: OR (95%CI) 0.84 (0.67-1.04) (P = 0.11). HDL
cholesterol levels were lower in RA patients: weighted mean difference -17.72
mg/dl (-18.35 - -17.08) (P < 0.00001). Significant heterogeneity among studies
was found for diabetes mellitus and HDL cholesterol levels. CONCLUSIONS: Some
traditional cardiovascular risk factors, such as smoking, diabetes mellitus or
lower HDL cholesterol levels, appear more prevalent in rheumatoid arthritis
patients and could contribute to the increased cardiovascular morbidity and
mortality observed in rheumatoid arthritis.
CI - Copyright (c) 2010 Societe francaise de rhumatologie. Published by Elsevier SAS.
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Langue : ANGLAIS