TITLE:
Cardiovascular Risk Burden in Sub-Saharan Africans with Rheumatoid Arthritis: A Hospital-Based Study in Yaounde, Cameroon
AUTHORS:
Madeleine Singwe-Ngandeu, Mickael Essouma, Vicky Jocelyne Ama Moor, Ahmadou Jingi Musa, Alain Patrick Menanga, Caroline Ngoufack, Sandrine Sa’a Lontsi, Thierry Ntandzi, Yolande Vanessa Ayi Efoua, Mireille Cathy Melong Pianta
KEYWORDS:
Rheumatoid Arthritis, Excess Adiposity, Physical Inactivity, Cardiovascular Risk, World Health Organization Risk Charts
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.6 No.1,
February
16,
2016
ABSTRACT: Introduction: Studies on RA (rheumatoid arthritis) and cardiovascular risk in African countries
are scarce. Objective: To investigate the relationship between RA and cardiovascular risk in Cameroonian
patients. Methodology: In 50 Black RA patients and 51 matched healthy individuals
from the general population, we studied cardiovascular risk factors validated by the WHO. Cardiovascular
risks estimates were carried out using WHO risk charts for the African region. Epi-info,
R and SPPS were used for the statistical analysis. Results: Overall and abdominal adiposity as expressed
by increased body mass index and abdominal obesity, were all markedly increased in RA
patients compared to non-RA subjects [70% vs. 47%, OR (95% CI) = 2.62 (1.16 - 5.94), p = 0.026;
and 54% vs. 33%, OR (95% CI) = 2.34 (1.05 - 5.25), p = 0.045 respectively]. RA patients were more
physically inactive than their non-RA counterparts (20% vs. 0, p = 0.001). Whereas RA was associated
with a reduced odds of alcoholism [OR (95% CI) = 0.19 (0.06 - 0.62), p = 0.005]. Increased
BMI seemed to occur independently of methotrexate (p = 0.76), hydroxychloroquine (p = 0.59),
corticosteroids (p = 0.79) treatments, and independently of sex (p = 0.15), age (p = 0.67), and sedentary
lifestyle (p = 0.16) in RA patients; but their BMI was weakly correlated with disease duration
(r = 0.26; p = 0.074). Meanwhile, male gender was associated with a reduced odds of abdominal
obesity [OR (95% CI) = 0.02 (0 - 0.4), p = 0.011]. Cardiovascular risk, comparable by proportions
between RA and non-RA subjects, was low in 26 patients (78.8%) and 30 non-RA subjects
(83.3%) respectively. Conclusion: Despite the high adiposity burden and a sedentary lifestyle experienced
by RA patients compared to their healthy counterparts, RA was not associated with cardiovascular
risk as estimated by WHO risk charts.