Rheumatoid arthritis (RA) is an autoimmune form of arthritis that impacts more than just your joints. It can also affect other tissues and organs, potentially causing issues in the heart.
However, having RA doesn’t necessarily mean you’ll experience heart problems. There are proactive steps you can take to maintain heart health and reduce your risk of developing heart disease.
Continue reading to learn about the connection between RA and heart disease, as well as ways to lower your risk factors if you are living with RA.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disorder, which means your immune system overreacts and mistakenly attacks healthy cells. This leads to chronic swelling and inflammation, causing pain and deformity in the affected areas.
RA typically affects the joints in the following areas:
- Hands
- Wrists
- Knees
Chronic inflammation from RA can impact more than just the joints; it can also lead to complications involving the heart, lungs, and eyes.
How Does RA Affect Heart Health?
Chronic inflammation associated with RA increases the risk of heart disease. This inflammation can damage blood vessels and lead to the buildup of plaque in the arteries. Plaque buildup can narrow these vessels, impeding blood flow and potentially resulting in a heart attack or stroke.
Proteins known as cytokines play a key role in the growth and activity of other immune system cells. These proteins are instrumental both in the way RA attacks the joints and in how it damages blood vessels in cardiovascular disease.
Shared Risk Factors
Inflammation isn’t the only connection between RA and heart disease. Many risk factors for RA overlap with those for heart disease.
Shared risk factors include:
High Blood Pressure
People with RA may have higher blood pressure due to:
- Lack of exercise
- Certain medications that treat RA, such as steroids
- Less elastic arteries
Inflammation is also linked to higher blood pressure. Individuals with RA may experience up to ten times the amount of inflammation compared to those without RA.
Obesity
Obesity may be linked to an increased risk of developing RA. While the exact connection remains unclear, the Arthritis Foundation suggests that sore joints associated with RA can make exercising difficult, leading to weight gain.
Moreover, obesity is associated with inflammation and other risk factors for heart disease, such as high blood sugar and high blood pressure.
Obesity is also linked to metabolic syndrome, a cluster of conditions including high triglycerides and cholesterol, high blood pressure, and high blood sugar. Metabolic syndrome is twice as common in people with RA compared to those without it.
Lipid Paradox
RA uniquely affects fats in the bloodstream. People with RA typically exhibit:
- Low levels of LDL (“bad” cholesterol)
- High levels of triglycerides
- Low levels of HDL (“good” cholesterol)
While low levels of LDL are generally associated with better heart health, the combination of low HDL and high triglycerides can increase the risk of heart disease.
Smoking
People who smoke are more likely to develop RA than those who do not. If you smoke and have RA, you’re also at a greater risk of experiencing more severe RA symptoms compared to non-smokers.
In addition to increasing the risk of developing RA and exacerbating joint damage, smoking is a major contributor to heart disease, according to the Centers for Disease Control and Prevention (CDC). Individuals who smoke and have RA are 50 percent more likely to develop heart disease than those with RA who do not smoke.
How to Reduce the Risk
Although RA increases the risk of heart disease, there are several ways to lower this risk with the help of your doctor.
One of the most effective ways to protect yourself from RA-related heart disease is to take the prescribed medications to control RA inflammation. Disease-modifying antirheumatic drugs (DMARDs) reduce inflammation associated with RA and may also lower the risk of heart disease.
While people living with RA have an elevated risk of heart disease, medical guidelines in the United States do not currently offer specific recommendations to mitigate this risk. However, the European League Against Rheumatism (EULAR) suggests that individuals with RA should be screened for heart disease risk factors every five years.
You can also implement lifestyle changes to help lower your risk of heart disease. The American Heart Association offers the following tips:
- Eat a balanced diet rich in vegetables, fruits, and whole grains.
- Engage in at least 150 minutes of aerobic exercise per week.
- Maintain a moderate weight.
- Avoid smoking or quit if you currently smoke.
- Manage health conditions that raise your risk of heart disease, such as RA.
- Take any medication prescribed by your doctor to prevent heart disease, such as statins.