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What Rheumatoid Arthritis Does to Your Heart


Linda Wasmer Andrews

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When you have rheumatoid arthritis (RA), you’re sure to notice any painful, swollen joints. But it’s important not to overlook what’s happening in the rest of your body, too, including your heart and blood vessels.

Higher Risk of Heart Disease

For people with RA, a disease that causes joint inflammation, the risk of dying from cardiovascular disease is up to 50% higher than in the general population. In fact, cardiovascular disease is actually the number one cause of premature death in people with RA.

That doesn’t mean you’re automatically doomed to have a heart attack, however. Even if you have RA, there’s a lot you can do to reduce your risk. Two keys to protecting your heart are reducing body-wide inflammation and choosing a heart-smart lifestyle.

Inflammation and Atherosclerosis

RA inflames the joints, but its effects don’t stop there. People with RA may also have more widespread inflammation throughout their bodies, which can affect the body’s organs and tissues.

Long-lasting inflammation can damage the endothelial cells that line the insides of arteries. The damage promotes the development of plaque—a buildup of cholesterol, fat, calcium, and other substances in the blood. Over time, plaque hardens and narrows the arteries, limiting the flow of oxygen-rich blood. This condition, known as atherosclerosis, can cause heart disease if it occurs in the arteries to the heart.

Enough to Give You a Heart Attack

RA has been linked to several kinds of heart problems, including:

  • Atrial fibrillation. This condition, the most common type of heart rhythm problem, occurs when the upper chambers of the heart beat very fast and irregularly. Left untreated, it can lead to a stroke or heart failure. People with RA have an increased risk of developing atrial fibrillation.

  • Heart attack. Plaque sometimes builds up inside arteries that supply the heart, narrowing them. The presence of plaque increases the chance that a blood clot will form. If a piece of plaque or a blood clot blocks the flow of blood to the heart, the result is a heart attack. The risk of having a heart attack is up to two times higher in people with RA, compared with those without RA.

  • Heart failure. This condition occurs when the heart is unable to pump enough blood to meet the body’s demands. People with RA are more likely than those without RA to develop heart failure and die soon afterward.

  • Pericarditis. In this condition, the membrane enclosing the heart becomes inflamed, leading to chest pain and sometimes disrupting the heart’s normal rhythm. Chronic RA inflammation may cause long-lasting pericarditis.

The Ticket to a Healthier Ticker

In general, the more severe your RA, the greater your chance of developing heart problems. To protect your heart, it’s important to get inflammation under control. And the sooner you can do this the better, because the risk of having a heart attack goes up within the first year after being diagnosed with RA. Work with your doctor to find the arthritis treatment that’s most effective for you.

To further reduce your risk of heart problems, stay physically active, eat a balanced diet, maintain a healthy weight, and don’t smoke. Ask your doctor or a dietitian for suggestions on making lifestyle changes successfully.

High blood pressure, unhealthy cholesterol levels, and diabetes only add to your risk of developing heart disease. If you need medication to treat any of these conditions, be sure to take it as directed.

RA Medicines and Your Heart

Unfortunately, some medications used to treat RA might actually put your heart in greater jeopardy. On balance, these medications are still helpful for many people. But the risks and benefits of these medications should be carefully weighed with your doctor:

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 20, 2017

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Medical References

  1. Choy E et al. Cardiovascular risk in rheumatoid arthritis: recent inflammation, risk predictors and the impact of treatment. Rheumatology. 2014;53(12):2143-54.
  2. More Than Just Joints: How Rheumatoid Arthritis Affects the Rest of Your Body. Arthritis Foundation.
  3. Rheumatoid Arthritis Treatment. Arthritis Foundation.
  4. Arthritis and heart disease. Arthritis Foundation.
  5. How RA Inflammation Affects Your Heart. Arthritis Foundation.
  6. NSAIDs and the Risk of Heart Problems and Stroke. Arthritis Foundation.
  7. What is Atrial Fibrillation? National Institutes of Health. National Heart, Lung and Blood Institute.
  8. What Are the Signs and Symptoms of Atrial Fibrillation? National Institutes of Health. National Heart, Lung and Blood Institute.
  9. What is Atherosclerosis? National Institutes of Health. National Heart, Lung and Blood Institute.
  10. What is Heart Failure? National Institutes of Health. National Heart, Lung and Blood Institute.
  11. What is Pericarditis? National Institutes of Health. National Heart, Lung and Blood Institute.
  12. Rheumatoid Arthritis. National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases.    

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