Better Diagnosis, Treatments, Awareness and Risk Management Are Citied in New Mayo Clinic Study

SAN FRANCISCO — Developing rheumatoid arthritis (RA) no longer puts you at greater risk of dying from heart disease – a big change from generations past, researchers say.

The death rate from cardiovascular disease dropped from 7.9 percent for people diagnosed with RA in the 1990s to 2.8 percent for people diagnosed between 2000 and 2007, said the researchers. (They used statistical methods to calculate a 10-year incidence for both periods so they could be compared.) The cardiovascular death rate in the 2000s was about the same as in people without RA.

It’s not clear what’s driving the improvement, said Elena Myasoedova, MD, PhD, from the Mayo Clinic in Rochester, Minnesota. But she said the the reasons could include “improved diagnostics, early effective treatments currently available for patients with RA, and increased awareness and improved management of increased cardiovascular disease risk in RA.”

Researchers noted a connection between RA and heart disease long ago, but after decades of improved care for people with RA, Myasoedova and her colleagues wanted to know if the connection had changed.

So they looked at the records of 315 people who developed RA between 2000 and 2007 and compared them to the records of 498 people who developed RA in the 1990s. They also compared these groups to 813 people without the disease. Sixty-eight percent of people in the study were female, with an average age of nearly 60 years.

The researchers followed all the participants until the participants died or moved. They stopped tracking them on January 1, 2014. They got causes of death from state and local death certificates as well as the National Death Index Plus, a database of death records.

Not only did the overall cardiovascular disease death rate decline between the two groups with RA, the death rate from coronary heart disease – a type of cardiovascular disease caused by hardening of the arteries – dropped as well.

In the 1990s, the death rate from coronary heart disease was 4.7 percent among people with RA, and from 2000 to 2007 it was 1.2 percent, about the same as the people without RA.

Looking at it another way, the cardiovascular death rate dropped by 57 percent and the coronary heart disease death rate dropped about 80 percent in RA patients.

Myasoedova’s research team continues to investigate the reasons for the recent improvement in cardiovascular death in patients with RA. What they learn may help not only RA patients but everyone else as well, they say.