TY - JOUR
T1 - The effect of rheumatoid arthritis on the risk of cerebrovascular disease and coronary artery disease in young adults
AU - Chen, Yih Ru
AU - Hsieh, Fang I.
AU - Chang, Chi Ching
AU - Chi, Nai Fang
AU - Wu, Hsin Chiao
AU - Chiou, Hung Yi
N1 - Publisher Copyright:
© 2018
PY - 2018/9
Y1 - 2018/9
N2 - Background: Only a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. Methods: Data regarding 52,840 subjects (10,568 patients with RA and 42,272 age-, sex-, urbanization-, and income-matched non-RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. Results: RA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95% confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35-fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95% CI, 7.22–11.41) relative to subjects without RA and hypertension. Conclusion: RA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.
AB - Background: Only a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. Methods: Data regarding 52,840 subjects (10,568 patients with RA and 42,272 age-, sex-, urbanization-, and income-matched non-RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. Results: RA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95% confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35-fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95% CI, 7.22–11.41) relative to subjects without RA and hypertension. Conclusion: RA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.
KW - Cerebrovascular disorders
KW - Coronary artery disease
KW - Hypertension
KW - Rheumatoid arthritis
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U2 - 10.1016/j.jcma.2018.03.009
DO - 10.1016/j.jcma.2018.03.009
M3 - Article
AN - SCOPUS:85048561467
SN - 1726-4901
VL - 81
SP - 772
EP - 780
JO - Journal of the Chinese Medical Association
JF - Journal of the Chinese Medical Association
IS - 9
ER -