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Open Access Research article

Cardiovascular disease is increased prior to onset of rheumatoid arthritis but not osteoarthritis: the population-based Nord-Trøndelag health study (HUNT)

Helen Pahau1, Matthew A Brown1, Sanjoy Paul25, Ranjeny Thomas1* and Vibeke Videm34

Author Affiliations

1 University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Woolloongabba, QLD, Australia

2 Queensland Clinical Trials and Biostatistics Centre, School of Population Health, University of Queensland, Princess Alexandra Hospital, Wooloongabba, QLD, Australia

3 Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway

4 Department of Immunology and Transfusion Medicine, Trondheim University Hospital, Trondheim, Norway

5 Current address Clinical Trials & Biostatistics Unit, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia

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Arthritis Research & Therapy 2014, 16:R85  doi:10.1186/ar4527

Published: 2 April 2014

Abstract

Introduction

Patients with rheumatoid arthritis (RA) have increased risk of cardiovascular (CV) events. We sought to test the hypothesis that due to increased inflammation, CV disease and risk factors are associated with increased risk of future RA development.

Methods

The population-based Nord-Trøndelag health surveys (HUNT) were conducted among the entire adult population of Nord-Trøndelag, Norway. All inhabitants 20 years or older were invited, and information was collected through comprehensive questionnaires, a clinical examination, and blood samples. In a cohort design, data from HUNT2 (1995–1997, baseline) and HUNT3 (2006–2008, follow-up) were obtained to study participants with RA (n = 786) or osteoarthritis (n = 3,586) at HUNT3 alone, in comparison with individuals without RA or osteoarthritis at both times (n = 33,567).

Results

Female gender, age, smoking, body mass index, and history of previous CV disease were associated with self-reported incident RA (previous CV disease: odds ratio 1.52 (95% confidence interval 1.11-2.07). The findings regarding previous CV disease were confirmed in sensitivity analyses excluding participants with psoriasis (odds ratio (OR) 1.70 (1.23-2.36)) or restricting the analysis to cases with a hospital diagnosis of RA (OR 1.90 (1.10-3.27)) or carriers of the shared epitope (OR 1.76 (1.13-2.74)). History of previous CV disease was not associated with increased risk of osteoarthritis (OR 1.04 (0.86-1.27)).

Conclusion

A history of previous CV disease was associated with increased risk of incident RA but not osteoarthritis.