[Treatment of cardiovascular risk factors]

Z Rheumatol. 2016 Mar;75(2):173-80; quiz 181-2. doi: 10.1007/s00393-016-0064-8.
[Article in German]

Abstract

Cardiovascular (CV) events are among the most important comorbidities and are the major cause of death in inflammatory rheumatic diseases, such as rheumatoid arthritis (RA). Disease activity and traditional CV risk factors contribute to the total CV risk. Among the antirheumatic drugs used for long-term treatment of RA, non-steroidal anti-inflammatory drugs (NSAID) and glucocorticoids lead to an increased risk but disease-modifying antirheumatic drugs (DMARD), such as hydroxychloroquine, methotrexate and especially biologics significantly reduce the risk. Besides achieving the best possible disease control, rheumatologists should identify additional CV risk factors and also initiate adequate treatment in order to reduce or even eliminate the CV risk. When treating rheumatic diseases possible drug-induced elevation of CV risk must be considered. Finally, the CV risk should be regularly monitored.

Keywords: Antirheumatic drugs; Biologics; Glucocorticoids; Myocardial infarction; Rheumatoid arthritis.

MeSH terms

  • Antirheumatic Agents / administration & dosage*
  • Antirheumatic Agents / adverse effects*
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / prevention & control*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Monitoring / methods
  • Evidence-Based Medicine
  • Humans
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / drug therapy*
  • Risk Assessment / methods
  • Risk Factors
  • Treatment Outcome

Substances

  • Antirheumatic Agents