Cholesterol Levels

It’s well-known, at least among health care providers, that people with rheumatoid arthritis (RA) are at high risk for heart disease, probably because of widespread inflammation that impacts the joints as well as the arteries. For that reason, it’s incredibly important to stay on top of cardiovascular screenings, including simple blood tests that monitor your cholesterol levels. Yet a new study finds that only 37 percent of those with RA had gotten a cholesterol test within a two-year period.

The study, published in the journal Arthritis Care & Research, relied on health insurance claims data that was gathered between 2006 and 2010. Researchers found that RA patients who also had diabetes were substantially more likely to have had a cholesterol screening, though that number was still surprisingly low (55 percent) considering that diabetes is also a major heart disease risk factor.

One issue, according to the study, may be that many RA patients rely on a rheumatologist to serve as their primary care physician. Those who saw a rheumatologist as well as a non-rheumatology clinician (such as an internist) were 55 percent more likely to have gotten their cholesterol checked.

“Our data suggest that rheumatologists are less likely than other non‐rheumatology practitioners to initiate primary lipid screening in patients with RA,” the authors wrote.

They noted that rheumatologists might not be familiar with cardiovascular screening/treatment guidelines, or that they perceive cardiovascular health to be something that another doctor (such as an internist or cardiologist) ought to be handling.

While rheumatologists should take note of this gap in care, patients must as well. If you don’t have a separate primary care physician, consider getting one — or at least make sure your rheumatologist knows that you don’t have one. Ask your doctor how often you should be getting your cholesterol checked. Those with RA and especially those with RA and other cardiovascular risk factors (such as obesity or a family history of heart disease) should likely be tested more frequently than adults without these risk factors.

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Keep Reading

Diabetes, Heart Disease, and Stroke. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke.

Know Your Numbers. CardioSmart. American College of Cardiology. https://www.cardiosmart.org/Healthy-Living/Know-your-Numbers.

Navarro‐Millán I, et al. Screening of Hyperlipidemia Among Patients With Rheumatoid Arthritis in the United States. Arthritis Care & Research. December 2019. doi: https://doi.org/10.1002/acr.23810.

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