Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


The Association Between Cardio-Respiratory Fitness and Traditional Cardiovascular Risk Factors in Rheumatoid Arthritis Patients.

Cooney1,  Jennifer K., Ahmad2,  Yasmeen, Moore1,  Jonathan, Lemmey1,  Andrew, Jones1,  Jeremy, Maddison1,  Peter, Thom1,  Jeanette

School of Sport, Health and Exercise Sciences, Bangor University, George Building, Bangor, Gwynedd, LL57 2PZ, UK., Bangor, United Kingdom
The Department of Rheumatology, Betsi Cadwaladr University Health Board (West), Llandudno, LL30 1LB, UK, Bangor, United Kingdom

Background/Purpose:

RA is associated with increased mortality from cardiovascular disease (CVD). Traditional CVD risk factors do not fully explain this increased incidence. RA patients are typically known to have poor cardio-respiratory fitness (CRF), a known CVD risk factor. However their CVD risk factor profile needs further investigation. Thus the aim was to assess RA patients' CRF using a simple tool and to determine whether poor CRF correlated with traditional CVD risk factors.

Methods:

100 RA patients (69 female, 31 male) attending rheumatology clinics were recruited. CRF was measured using the Siconolfi Step Test. Patients were allocated into three groups based on their performance in the step test (i.e. unable to do the test, 'poor' fitness and 'better' fitness). RA activity/severity, traditional CVD risk factors, Framingham 10 year CVD risk and anthropometric characteristics were assessed.

Results:

RA patients had well controlled disease (table 1). Some CVD risk factors were mildly elevated but 32% and 28% of patients were taking medication for hypertension and hyperlipidemia respectively. Their Framingham Risk Score was moderate at 16%. Because patients' range of CRF was poor, expected correlations with CVD risk factors were not observed. Despite no difference in disease duration 'unable' patients rated their arthritis as worse, more painful and disabling. Their Framingham Risk was also significantly higher than 'better fitness' patients. 'Unable' patients were also fatter, had bigger waists and were classed as obese (BMI >30).

Table 1. RA characteristics, P<0.05; # 1 vs 2; * 1 vs 3; ̂ 2 vs 3

RA factorsTotal Group1. Unable (n=35)2. Poor (n = 33)3. Better (n = 32)
Age59.6 ± 10.262.2 ± 8.4*64.2 ± 7.2̂52.0 ± 10.6
Disease duration10.4 ± 9.111.0 ± 10.511.4 ± 9.38.7 ± 7.2
DAS28 CRP2.8 ± 1.43.0 ± 1.12.6 ± 1.12.6 ± 1.2
Global health (0–100)32 ± 2446 ± 24#*23 ± 2125 ± 19
Pain (0–100)23 ± 2835 ± 31*17 ± 2616 ± 20
HAQ.87 ± .761.46 ± .68#*.63 ± .52.55 ± .74
CRF    
  Step test22 ± 6 18 ± 426 ± 5
CVD risk factors    
  SBP140 ± 20141 ± 21146 ± 20̂132 ± 19
  DBP81 ± 1279 ± 1185 ± 11̂76 ± 12
  TC5.2 ± 1.15.2 ± 1.35.5 ± 1.05.3 ± 1.2
  TG1.5 ± .71.7 ± .7#1.3 ± .61.4 ± .7
  LDL3.1 ± 1.02.9 ± 1.03.1 ± .92.3 ± 1.0
  HDL1.5 ± .51.4 ± .41.7 ± .51.5 ± .4
Framingham risk (%)16 ± 1020 ± 11#*16 ± 811 ± 9
Anthropometry    
  BMI28 ± 631 ± 7*27 ± 525 ± 4
  Body fat %38 ± 1542 ± 18#*37 ± 1333 ± 11
  Waist hip ratio.90 ± .07.93 ± .07*.89 ± .07.88 ± .06

Conclusion::

The step test has emerged as a very useful tool, highlighting that RA patients have poor CRF and identifying those at greatest risk of developing CVD in the future. 'Unable' patients and those who perform poorly require medical intervention. This investigation has shown that screening for traditional risk factors may not be enough as the extent of their CVD risk is somewhat masked. Early detection of CVD risk using a tool like the step test could significantly reduce the CVD mortality in RA.

To cite this abstract, please use the following information:
Cooney, Jennifer K., Ahmad, Yasmeen, Moore, Jonathan, Lemmey, Andrew, Jones, Jeremy, Maddison, Peter, et al; The Association Between Cardio-Respiratory Fitness and Traditional Cardiovascular Risk Factors in Rheumatoid Arthritis Patients. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2566
DOI:

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