Factors Associated with Incidence of Cardiovascular Disease Among Patients with Rheumatoid Arthritis
Abstract
Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular disease (CVD). This thesis first explored risk factors affecting this association using a scoping review. The review included 33 cohort studies and showed that older age, male sex, co-morbid hypertension, diabetes, and/or dyslipidemia, the presence of rheumatoid factor (RF) and/or acute phase reactants, and glucocorticoids were associated with higher CVD incidence in RA patients. Using data from the Canadian Longitudinal Study on Aging (CLSA), Cox regression was used to explore whether RA increased CVD incidence among middle age and older individuals, accounting for various comorbidities, demographic, lifestyle and RA-related factors. RA patients experienced significantly more CVD incidence, compared to non-RA individuals (IRR = 1.69, 95% CI: 1.34 – 2.11). The stratified analysis showed that sex, age and education level were effect modifiers in the relationship between RA and CVD incidence.