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Can Heart Disease Be Prevented and Reversed?

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Is Rheumatoid Arthritis Linked To Heart Disease?
 

Being an autoimmune and inflammatory disease, rheumatoid arthritis (RA) can cause joint pain and damage throughout the body. Joints in the hands, wrists, and knees are commonly affected. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue. Such tissue damage can cause long-lasting or chronic pain, unsteadiness, and deformity. The joint damage that RA causes usually happens on both sides of the body. For instance, if a joint is affected in one of the arms or legs, the same joint in the other arm or leg will probably be affected. Other tissues throughout the body can also be affected and this can cause problems in organs such as the lungs, heart, and eyes.

RA is the result of an immune response in which the body’s immune system attacks its own healthy cells. While the specific causes of RA are unknown, certain factors can increase the risk of developing the disease. A few possible factors include age (onset of RA is highest among adults in their 60s); sex (new cases of RA are typically 2 to 3 times higher in women than men); smoking; history of live births (women who have never given birth may be at greater risk of developing RA); abnormal lipids; metabolic syndrome; and early life exposures (for instance, children whose mothers smoked had double the risk of developing RA as adults), and obesity.

People with RA are at a higher risk for developing other chronic diseases such as heart disease and diabetes. In fact, they are twice the risk for cardiovascular disease (CVD) than the general population. Chronic inflammation and some shared risk factors tend to increase the risk. Inflammatory substances called cytokines fuel joint destruction in RA and blood vessel damage in CVD. Inflammation causes plaque build-up in the arteries that slowly narrows blood vessels and blocks blood flow, and it is the main cause of heart attack and stroke. The other reason people with RA are more likely to develop heart disease is because of some shared risks. For example, metabolic syndrome from excess weight, insulin resistance, a high sugar high fat diet, and low fitness raises systemic inflammation by itself, but combined with the inflammation of RA, the inflammatory condition becomes more dangerous.

One study published online October 31, 2018 in journal ‘Scifed Journal of Cardiology’ revealed that approximately half of all deaths in people with RA are associated with CVD. Cardiovascular mortality is increased by 50 percent and the risk of CVD is increased by 48 percent among those with RA compared to the general population. The researchers also pointed out that among the major CVD presentations, silent heart attack, diastolic dysfunction, arrythmias, stroke and sudden cardiac death appear to be prevalent and occur at a relatively younger age. They concluded that chronic inflammation appears to be the major underlying pathogenic factor linking RA and CVD. This is linked to endothelial dysfunction, lipid abnormalities, hypercoagulability (excessive clotting disorder) and early atherosclerosis with unstable plaque formation.

Endothelial dysfunction is a kind of non-obstructive coronary artery disease (CAD) in which there are no heart artery blockages, but the large blood vessels on the heart's surface narrow instead of dilating opening.

Another study, which involved 4,305,225 participants with no history of heart failure when the study began, found that RA raised the risk of heart failure. The findings were published January 19, 2018 in the ‘Journal of the American Heart Association’.

Diagnosing RA may take time and require multiple laboratory tests to confirm clinical examination findings. Doctors will first perform physical examination of the joints of their patients, for instance, by looking for swelling and redness. If they suspect RA, they will most likely refer the patients to a specialist called a rheumatologist who may use several different types of blood tests to confirm the condition.

Treatments for RA help manage the pain and control the inflammatory response which can in many cases result in remission. Decreasing the inflammation can also help prevent further joint and organ damage. Treatment options may include medications; alternative or home remedies; dietary changes; specific types of exercise.

Date: August 27, 2020

 

 

 

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