Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease (CVD) and mortality compared to the general population.1-3 In a meta-analysis that included 111 758 patients, there were 22 927 cardiovascular events, including ischemic heart disease or cerebrovascular events.2 Although the American College of Rheumatology does not have specific guidelines on cholesterol screening for patients with RA, the American College of Cardiology and the American Heart Association (ACC/AHA) guideline recommends cholesterol screening every five years for the general population.4 The European League Against Rheumatism (EULAR) guideline for cardiovascular risk management also recommends CVD risk assessment for patients with RA at least once every five years, or sooner if patients have an intermediate risk score and rapid disease progression.5
In the United States, the applicable guidelines are those from the ACC/AHA. Obtaining a cholesterol test is of critical importance as it is the first step towards assessing the overall CVD risk.
- Mutru O, Laakso M, Isomaki H, Koota K. Ten year mortality and causes of death in patients with rheumatoid arthritis. Br Med J (Clin Res Ed). 1985;290(6484):1797-1799.
- Avina-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum. 2008;59(12):1690-1697.
- Mutru O, Laakso M, Isomäki H, Koota K. Cardiovascular mortality in patients with rheumatoid arthritis. Cardiology. 1989;76(1):71-77.
- Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Circulation. 2018:CIR0000000000000625.
- Agca R, Heslinga SC, Rollefstad S, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2017;76(1):17-28.