HCR.20.029 – Cardiovascular disease risk in women with rheumatoid arthritis and the influence of menopause: a burning heart?

Route: Health care research, sickness prevention and treatment

Cluster question: 088 How can we predict, prevent, and treat cardiovascular diseases (atherosclerosis, heart failure, heart arrhythmia, and thrombosis) in individuals at an early stage?

The cardiovascular risk is increased in patients with rheumatic diseases. Also, women of child bearing age have a lower cardiovascular disease (CVD) risk compared to men, due to estrogen, which alters after menopause. Given that rheumatoid arthritis (RA) increases the CVD risk by 2, we hypothesize that in women with this disease, menopause may have an additional detrimental effect on cardiovascular risk, with implications for screening and therapy.
The primary aim is to compare the CVD risk in women with RA with healthy controls, matched for sex, age and menopausal status. The secondary aim is to study the difference in cardiovascular risk between pre-and post-menopausal patients with RA and controls.
Three hundred women with RA will be matched in a cross-sectional study with a healthy woman of similar age and menopausal status. In total 300 female controls will be recruited. Half of the participants should be pre-menopausal and half post-menopausal.
In addition to medical history and physical examination, serum samples will be obtained to test for cardiovascular risk factors (serum lipid profile, glucose, N-terminal-pro-B-type natriuretic peptide, High-sensitivity cardiac troponin concentration). An Electrocardiogram, Transthoracic echography, ultrasound of the carotid arteries (carotid intima media thickness, arterial stiffness by pulse wave velocity measurements, Coronary Artery Calcium score assessed with Computed Tomography, Whole Body Dexa scans will be obtained.
RA patients will be compared with controls, matched for age and the cardiovascular risk in premenopausal and postmenopausal status
New data will emerge on the specific CV risk factors in women with rheumatic diseases and the additional CVD risk of menopause. This might result in early and preventive measures in order to decrease of cardiovascular events and mortality and subsequently will improve the quality of life of women with RA.

Keywords

Cardiovascular diseases, menopause, rheumatic diseases

Other organisations

NA

Submitter

Organisation Amsterdam UMC, Location Vumc (VUMC)
Name Prof.dr I.E. (Irene) van der Horst-Bruinsma, rheumatologist
E-mail ie.vanderhorst@amsterdamumc.nl
Website https://www.vumc.nl/zorg/uw-artsen-en-zorgverleners/zorgverlener/dr.-irene-van-der-horst-bruinsma.htm