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.

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.

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.

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

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).

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 (heart, brain, legs, lungs) by decreasing the natural anticoagulants (which hinder the clotting of blood) that our body produces.

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.

Yes, remember that inflammation = promotion of blood clotting.

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.

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 to your doctor to find out the lowest dose and the shortest duration that you need it. Prednisone is never the only treatment for arthritis.

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.

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.

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.

There isn’t a cure for arthritis because we still do not know the cause. We are getting there – that’s why we have new treatments.

Tests should be ordered with a purpose rather than to see what is abnormal.

New research suggest that CBD helps for sleep and pain. THC is not recommended. But most “oils” have both CBD and THC (the ratio should be 1:10).

You can often rely on a low CRP level. But there are some patients who will have active disease and normal CRP. Keep in mind that CRP is not specific and other conditions (e.g. infection, weight, etc.) can also elevate CRP. Clinical exams in combination with labs and symptoms reported by the patient are most important.

No, it is usually pain, redness and swelling.

Yes, prednisone is the usual one. Other medications are safe.

Yes, we do not recommend NSAIDs as first-line therapy, but they can be taken long term if they help and favourably impact quality of life. But close monitoring is needed. Risks and benefits need to be weighed by the patient and doctor.

If the disease has been under good control and the patient has no other risk factors for cardiovascular disease, then the risk is close to that of the general population.

Osteoarthritis has also been associated with increased risk of cardiovascular disease, but to a lesser extent than other truly inflammatory types of arthritis.

Naproxen has a safer profile for cardiovascular disease.

Yes, for people with thickening of the carotid arteries by cholesterol, this is an indirect way to screen for atherosclerosis and risk of stroke or heart attacks. It is done by ultrasound and is not an invasive test. Highly recommended for patients with a family history of stroke or heart disease – especially if occurred before age 60.

Yes, screen for cardiovascular disease like they do for diabetes as the risk of cardiovascular disease is similar between the two diseases.

No, PHARMA develops new therapies using knowledge obtained via research. Not all research is done by big PHARMA. In fact, most of the research is done independently.

If you haven’t developed cardiovascular disease by now and your disease is under control, your risk is low. Remember, our data suggests that the highest risk is early on in a person’s disease.

It is hard to know. But it is possible that she may have had hereditary disorders of lipids or other diseases that provoke early heart attacks.

Tylenol can be taken for life. It is very safe but the dose has to be right: 1 gram x 3 /day.

Yes, but the inflammation in osteoarthritis is less than in rheumatoid arthritis.

I am not aware of good research assessing this question. However, theoretically, it will be unlikely as there is no evidence to my knowledge that cannabis works on inflammation.

Yes, Naproxen and Aspirin can actually be protective. However, they still increase the risk of kidney toxicity if taken for prolonged periods of time.

Yes, because you would have two inflammatory conditions at once.