TITLE:
Review of Literature Investigating the Correlation between Prevalence of Risk Factors Associated with Both Rheumatoid Arthritis and Cardiovascular Diseases
AUTHORS:
Sarah Al-Gahtani
KEYWORDS:
Autoimmune Diseases, Heart Diseases, Rheumatoid Arthritis, Cardiovascular Diseases, Common Risk Factors, Precision Medicine
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.16 No.1,
December
30,
2025
ABSTRACT: The increased risk of cardiovascular morbidity and mortality in rheumatoid arthritis has been increasingly acknowledged in past decades, with accumulating evidence that rheumatoid arthritis is an independent cardiovascular risk factor. We will discuss the latest evidence in this respect. Cardiovascular disease risk management for patients with rheumatoid arthritis is essential. Clinical guidelines and implementation of cardiovascular risk management in daily clinical practice. One of the most applied forms of literature reviews is systematic reviews, which prioritizes real-world applicability over strict methodological constraints, making it ideal for public health and clinical decision-making. These reviews focus on clinical relevance, seeking to inform policy and practice by integrating findings in a way that directly translates into decision-making. An example is a recent review evaluating correlation between the prevalence of rheumatoid arthritis and cardiovascular diseases. Objectives: To review the literature that examines rheumatoid arthritis (RA)-cardiovascular diseases (CVD) association using statistical and epidemiological concepts from studies that are concerned with these important issues. In this Review, we will discuss epidemiological data on cardiovascular disease in rheumatoid arthritis, not only for atherosclerotic disease but also for venous thrombotic disease and heart failure, as clinical and subclinical prevalence of the two diseases is higher than previously thought. The underlying pathophysiology of increased cardiovascular risk relevant to inflammatory arthritis, as well as the observed effect of anti-inflammatory and disease modifying treatments, will be reviewed and discussed. Methods: We followed the main steps in writing a systematic review and scientifically formulated cardiovascular research questions addressing epidemiological and pathophysiological aspects of rheumatoid arthritis, cardiovascular effects of drug treatment, and management of cardiovascular risk. References for this Review were identified through searches of PubMed with the terms “rheumatoid arthritis”, “cardiovascular disease”, “cardiovascular event”, “myocardial ischemia”, “stroke”, “coronary disease”, “congestive heart failure”, “cardiac dysfunction”, and “cardiovascular risk management” from January 1, 1998, to April 1, 2022. Only papers published in English were reviewed. The final reference list was generated based on originality and relevance to the broad scope of this Review. In Figure 1, we use PRISMA to map our review strategy. The inclusion-exclusion criteria are: Inclusion criteria: Adults aged > 25 years with a diagnosis of RA. Studies had to report on one or more factors associated with incident CVD in RA patients. Only studies written in English were included. Exclusion criteria: Children aged ≤ 25 years, studies that did not include any subjects with an RA diagnosis, prevalent CVD (cases with a prior history of CVD) and/or studies that did not assess risk factors associated with incident. Findings: There are several risk factors that are linked to both diseases. The literature confirmed that the increased risk of cardiovascular events in patients with RA is multifactorial. The traditional risk factors, such as smoking, hypertension, and hyperlipidemia, are of course still important, and the presence of RA exerts an additional independent risk. We emphasize the importance of precision medicine to address conflicting evidence of the treatment effect on stroke among RA patients.