Researchers at Brigham and Women’s Hospital (BWH) have found that women with rheumatoid arthritis may significantly increase their risk of heart attack by approximately two-fold over an extended period of time. The findings appear in the March 11th issue of Circulation: Journal of the American Heart Association.

“We examined the rates of heart attack and rheumatoid arthritis in more than 114,000 women and found that there appears to be a strong correlation between the two conditions,” said Daniel Solomon, MD, MPH, a rheumatologist and epidemiologist at BWH. “This study indicates that both physicians and patients should recognise rheumatoid arthritis as a marker for increased heart attack risk.”

The researchers found that women with rheumatoid arthritis appeared to double their risk of heart attack compared to women with no history of the disease. The risk was even higher for women who suffered from arthritis for an extended period of time. Those women who had rheumatoid arthritis for at least ten years at the onset of the study increased their risk of heart attack three-fold. The data showed no correlation between stroke risk and arthritis.

“Our study, the largest of its kind to date, illustrates the importance of considering more aggressive cardiac preventive measures in arthritic patients,” said Solomon. “The data indicate that it would be useful to examine how pharmacological and lifestyle interventions may be able to reduce the risk of cardiovascular disease in a very high-risk patient population,” he added. As the evidence linking rheumatoid arthritis and heart attack risk strengthens, Solomon, also of Harvard Medical School, suggests that inflammation may be the common catalyst for both diseases. “We have long known that inflammation is a hallmark of rheumatoid arthritis and new research suggests that heart disease also has an important inflammatory component. Given this possible shared pathway, future research will need to determine whether early treatment of arthritis with anti-inflammatory drugs may also reduce the future risk of heart attacks,” Solomon concluded.

These findings were based on data collected from 114,342 women enrolled in the BWH-based Nurses’ Health Study. Self-reported cases of rheumatoid arthritis and cardiovascular disease (confirmed by medical record review) were analyzed over twenty years. During this period, the researchers documented diagnosis of rheumatoid arthritis in 527 women and confirmed 2,296 heart attacks and 1326 strokes.