{"id":598,"date":"2019-01-24T15:44:08","date_gmt":"2019-01-24T15:44:08","guid":{"rendered":"https:\/\/www.healthnews.ie\/news\/getting-to-the-heart-of-the-matter-in-rheumatoid-arthritis\/"},"modified":"2020-02-20T12:22:15","modified_gmt":"2020-02-20T12:22:15","slug":"cardiovascular-rheumatoid-arthritis","status":"publish","type":"post","link":"https:\/\/www.healthnews.ie\/bones-and-joints\/cardiovascular-rheumatoid-arthritis\/","title":{"rendered":"Getting to the heart of the matter in rheumatoid arthritis in Ireland"},"content":{"rendered":"\n<div style=\"background-color:#f2f2f2;color:#32373c\" class=\"wp-block-atomic-blocks-ab-profile-box round ab-has-avatar ab-font-size-14 ab-block-profile ab-profile-columns\"><div class=\"ab-profile-column ab-profile-avatar-wrap\"><div class=\"ab-profile-image-wrap\"><figure class=\"ab-profile-image-square\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" class=\"ab-profile-avatar wp-image-839\" src=\"https:\/\/s3.eu-north-1.amazonaws.com\/cdn-site.mediaplanet.com\/app\/uploads\/sites\/94\/2019\/01\/07211756\/Sinead-Harney-Heashot.jpg\" alt=\"\" srcset=\"https:\/\/s3.eu-north-1.amazonaws.com\/cdn-site.mediaplanet.com\/app\/uploads\/sites\/94\/2019\/01\/07211756\/Sinead-Harney-Heashot.jpg 200w, https:\/\/s3.eu-north-1.amazonaws.com\/cdn-site.mediaplanet.com\/app\/uploads\/sites\/94\/2019\/01\/07211756\/Sinead-Harney-Heashot-125x125.jpg 125w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/figure><\/div><\/div><div class=\"ab-profile-column ab-profile-content-wrap\"><h2 class=\"ab-profile-name\" style=\"color:#32373c\"><strong>Sinead Harney<\/strong><br \/><\/h2><p class=\"ab-profile-title\" style=\"color:#32373c\">Rheumatology Department, Cork University Hospital<\/p><div class=\"ab-profile-text\"><\/div><ul class=\"ab-social-links\"><\/ul><\/div><\/div>\n\n\n\n<p><em>1% of the world live with rheumatoid arthritis, that\u2019s 21 million people: 45,000 of those live in Ireland.<\/em><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p>Rheumatoid arthritis (RA) is a chronic progressive autoimmune disease. It also affects the synovial joints predominantly of the hands and feet, in a symmetrical distribution<sup>1<\/sup>. Chronic inflammation results in progressive joint damage which as a result, can end in arthralgia, joint deformity, decreased functional ability, prolonged disability and sometimes premature death<sup>2<\/sup>. In fact 1%<sup>3  <\/sup>of the world have RA. For this reason about 3 million people living with RA in Europe.  Similarly, according to Arthritis Ireland, 45,000 people suffer from the disease in this country.<\/p>\n\n\n\n<p>RA is twice as common in women as men and the usual age of onset is between 35-50 years.&nbsp; <\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p>Rheumatoid arthritis was only <a href=\"https:\/\/www.healthnews.ie\/bones-and-joints\/improve-treatment-gout\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"distinguished from gout (opens in a new tab)\">distinguished from gout<\/a> and osteoarthritis in 1922.<strong>However, it had featured in the paintings of artists in the seventeenth century.<\/strong><\/p><\/blockquote>\n\n\n\n<p>Rheumatoid arthritis mainly affects the synovial joints, but many patients have extra-articular manifestations which can be serious. In particular, there is a substantial excess of infection and vascular disease; 50% of deaths in RA patients are attributable to cardiovascular disease resulting in&nbsp;heart failure, stroke and myocardial infarction<sup>4<\/sup>. These can shorten life expectancy anything from three up to 18 years<sup>5.<\/sup><\/p>\n\n\n\n<p>Factors contributing to this increased risk include traditional cardiovascular (CV) risk factors. Hence, these included: age, gender, dyslipidaemia, hypertension, smoking, obesity and diabetes mellitis (DM), which partially explain the excess CV risk.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>The need for more targeted treatment of cardiovascular risk<\/strong><\/h2>\n\n\n\n<p>Comorbidities in patients with chronic diseases including RA have been shown to be under-recognised and under-treated with wide variability existing between countries with respect to their prevalence, detection and compliance with recommendations for prevention and management<sup>6<\/sup>. Guidelines published by <a href=\"https:\/\/www.eular.org\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"EULAR (opens in a new tab)\">EULAR<\/a> advise aggressive management of these traditional risk factors with tight RA disease management to try and combat cardiovascular disease for these patients<sup>7.<\/sup><\/p>\n\n\n\n<p>As our department is similar to others in Ireland, we are engaging with others in Galway and Sligo to examine RA and CV more closely. All of this work highlights a need for more targeted treatment of cardiovascular risk and has led us to consider establishing an ANP-led cardiac clinic here in Cork University Hospital to address this deficit.<\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p><sup>1: Aletaha et al 2010&nbsp; |&nbsp; <\/sup><sup>2: Scheinecker al 2008&nbsp; |&nbsp; 3: Shapira et al 2010<\/sup><sup>&nbsp; |&nbsp; 4: O\u2019Sullivan 2014<\/sup><br><sup>5: Solomon et al 2003<\/sup><sup>&nbsp; |&nbsp; 6: Dougadas et al 2014<\/sup><sup>&nbsp; |&nbsp; 7: Agca et al 2017<\/sup><\/p>\n","protected":false},"excerpt":{"rendered":"<p>1% of the world live with rheumatoid arthritis, that\u2019s 21 million people: 45,000 of those live in Ireland.<\/p>\n","protected":false},"author":22,"featured_media":1220,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[131],"tags":[],"class_list":["post-598","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bones-and-joints"],"acf":[],"featured_image_src":"https:\/\/s3.eu-north-1.amazonaws.com\/cdn-site.mediaplanet.com\/app\/uploads\/sites\/94\/2019\/02\/07211634\/health-skin-dermatology-product-reaction-hands-600x400.jpg","featured_image_src_square":"https:\/\/s3.eu-north-1.amazonaws.com\/cdn-site.mediaplanet.com\/app\/uploads\/sites\/94\/2019\/02\/07211634\/health-skin-dermatology-product-reaction-hands-600x600.jpg","author_info":{"display_name":"Health Awareness","author_link":"https:\/\/www.healthnews.ie\/author\/jennyhyndman\/"},"vicky_index_order":"","_links":{"self":[{"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/posts\/598","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/users\/22"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/comments?post=598"}],"version-history":[{"count":9,"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/posts\/598\/revisions"}],"predecessor-version":[{"id":4292,"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/posts\/598\/revisions\/4292"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/media\/1220"}],"wp:attachment":[{"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/media?parent=598"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/categories?post=598"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthnews.ie\/wp-json\/wp\/v2\/tags?post=598"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}