Cardiovascular Disease is a Serious and Life-Threatening Arthritis Complication 

It usually strikes before age 60 and most often in the first year after diagnosis when inflammation is highest. The thought of having a heart attack at age 40 or 50 is not top of mind for most because, in the general population, cardiovascular disease is more common after age 60. Yet, heart attacks, strokes and blood clots in the legs and lungs are the leading cause of death in arthritis patients. Through research, our scientists are determining the risk factors in different types of arthritis and finding ways to prevent this complication.

Below are some of the more frequently asked questions, related research articles, videos, and general information that may be helpful in understanding the connection between cardiovascular disease and arthritis. We hope that building public awareness and knowledge about this less-known arthritis complication will encourage people to take steps to improve their health and reduce their risk.

Frequently Asked Questions

How do I know if my medications increase or decrease my risk of cardiovascular disease?

Ask your doctor or pharmacist. Be proactive and take your health into your own hands. It’s important to understand that the risk of cardiovascular disease associated with some medications may be rare and sometimes uncontrolled inflammation is the most important risk factor. 

What member of my care team should I talk to about my risk of cardiovascular disease?

You should speak to your primary care doctor and rheumatologist, but you should also be proactive and make shared decisions that take into consideration both benefits and risks.

As someone who has been recently diagnosed with arthritis, do I need to worry about my risk of cardiovascular disease?

Yes, our research shows that the highest risk of cardiovascular disease (including heart attacks, strokes and blood clots in the legs and lungs) is within the first year after diagnosis when inflammation is at its peak.

Does the risk of cardiovascular disease differ by type of arthritis?

Yes, risk is higher for diseases with a more systemic and prolonged inflammation (e.g. lupus).

If I'm at high risk to develop cardiovascular disease, how much of this risk is related to my arthritis versus my medications?

It is always a combination of both. It’s important to tackle inflammation first and then avoid prolonged use or high doses of medications with an increased risk of cardiovascular disease (e.g. prednisone).

What is the connection between inflammation and risk of cardiovascular disease?

Systemic inflammation increases the risk of damaging the wall of the heart arteries, which facilitates atherosclerosis – a condition where plaque builds up inside the arteries. Moreover, systemic and uncontrolled inflammation promotes blood clots (heat, brain, legs, lungs) by decreasing the natural anticoagulants (which hinder the clotting of blood) that our body produces.

Are there changes that I can make to my lifestyle to lower my risk of developing cardiovascular disease?

Yes, control your weight. If you smoke, quit. Do moderate physical activity for 30-40 minutes, four times per week. Eat a healthy diet (vegetables, proteins and low carbs). Then, take your medications to control inflammation and prevent complications.

Is my risk of having a cardiovascular event heightened when I’m having a flare?

Yes, remember that inflammation = promotion of blood clotting.

I’m not taking any medications to manage my arthritis. What is my risk of cardiovascular disease?

That depends on the type of arthritis you have and your disease activity. However, the risk can go from 50 per cent to 400 per cent when compared to people from the general population who do not have arthritis.

Why is prednisone associated with an increased risk of cardiovascular disease?

Prednisone promotes diabetes, elevates cholesterol, and increases blood pressure. It, therefore, promotes accelerated atherosclerosis – plaque build-up in the arteries. If you need to be on prednisone, then talk your doctor to find out the lowest dose and the shortest duration that you need it. Prednisone is never the only treatment for arthritis.

How have advancements in arthritis treatment changed the risk for cardiovascular disease associated with arthritis or arthritis medications?

Some old medications such as Plaquenil (hydroxychloroquine or methotrexate) have been shown to decrease the risk of cardiovascular disease. Some new therapies (e.g. biologics) have also been shown to decrease cardiovascular disease risk. By controlling inflammation, we are preventing CVD complications. Following your treatment plan is very important.

Does the risk of cardiovascular disease differ based on the year/era that someone was diagnosed with arthritis?

Yes, our research has shown that the risk of cardiovascular disease has reduced in recent years likely because patients and doctors are more aware of this risk and are taking the necessary steps to prevent complications by treating inflammation more aggressively.

Shall I stop my medications once my arthritis in controlled?

Usually not, the inflammation gets controlled with medications (disease modifying, anti-rheumatic drugs also known as DMARDs) and therefore, when you stop them, the inflammation will come back. However, for prednisone yes, it is recommended to use it for a short time and at the lowest possible dose. Talk to your rheumatologist about this.

Related Articles

Risk of heart attack has improved over time in rheumatoid arthritis patients

Rheumatoid arthritis patients at heightened risk for life-threatening blood clot

Antimalarials save lupus patients’ lives

Ankylosing spondylitis associated with increased risk of blood clot condition

Researchers look to physical therapy to get arthritis patients moving

Gout patients at higher risk of developing life-threatening blood clot

An interview with Dr. Hyon Choi

Informational Videos

PRECISION: Preventing Complications from Inflammatory Skin, Joint and Bowel Conditions

Risk of heart attack has improved over time in rheumatoid arthritis patients

A patient’s guide to managing cardiovascular risk in rheumatoid arthritis

Arthritis Patient Advisory Board

Arthritis Research Canada works for and with patients. Our Patient Advisory Board partners with our scientists to ensure that our research is relevant, meaningful and helpful.

Interested in learning more about the Arthritis Patient Advisory Board or how to get involved? Click here