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Cardiovascular risk management in patients with active ankylosing spondylitis: a detailed evaluation.

Heslinga SC, Van den Oever IA, Van Sijl AM, Peters MJ, Van der Horst-Bruinsma IE, Smulders YM, Nurmohamed MT - BMC Musculoskelet Disord (2015)

Bottom Line: CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients.The prevalences of hypertension (41% vs 31%) and smoking (43% vs 27%) were substantially higher in AS patients as compared to the general Dutch background population.Although the majority of all AS patients eligible for CV-RM received CV risk medication, CV-RM remains a challenge for treating physicians, as treatment targets were not achieved in three-quarter of the eligible patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Reade, Amsterdam, Netherlands. s.heslinga@reade.nl.

ABSTRACT

Background: Ankylosing spondylitis (AS) is an inflammatory disease with documented elevated cardiovascular (CV) risk due to systemic inflammation and a higher prevalence of CV risk factors. CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients. We assessed CV risk and evaluated guideline adherence according to the Dutch CV-RM guideline.

Methods: This study was conducted with a cohort of consecutive AS patients eligible for treatment with a tumor necrosis factor (TNF) -α inhibitor. Data from the Dutch National Institute for Public Health and Environment was used to compare the prevalence of CV risk factors in AS patients with the Dutch background population.

Results: In total, 254 consecutive AS patients were included. The prevalences of hypertension (41% vs 31%) and smoking (43% vs 27%) were substantially higher in AS patients as compared to the general Dutch background population. Of 138 AS patients older than 40 years the 10-years CV risk could be calculated. Fifty-one of these 138 patients (37%) had an indication for CV risk treatment. CV risk treatment was initiated in 42 of the 51 (82%), however, in only 12 of the 51 (24%) patients treatment targets for either hypertension or hypercholesterolemia were reached.

Conclusion: The increased rates of hypertension and smoking illustrate the importance of CV-RM in AS patients. Although the majority of all AS patients eligible for CV-RM received CV risk medication, CV-RM remains a challenge for treating physicians, as treatment targets were not achieved in three-quarter of the eligible patients.

No MeSH data available.


Related in: MedlinePlus

Prevalences of hypertension (A), overweight (B) and hypercholesterolemia (C) in AS patients compared to the general Dutch population in four different age categories. Legend: X-axis: age categories, Y-axis: percentage, black: ankylosing spondylitis population, grey: general Dutch population.
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Fig1: Prevalences of hypertension (A), overweight (B) and hypercholesterolemia (C) in AS patients compared to the general Dutch population in four different age categories. Legend: X-axis: age categories, Y-axis: percentage, black: ankylosing spondylitis population, grey: general Dutch population.

Mentions: Of 254 AS patients, eight patients (3%) had a history of CVD and five patients (2%) were diagnosed with type 2 DM. One-hundred-and-nine patients (43%) smoked (45% of the men and 38% of the women) compared to 27% of the general Dutch population (30% of the men and 24% of the women) p = 0.001. Mean BMI was 26.2 ± 4.6, 134 patients (53%) were overweight and 44 patients (17%) were obese. Hypertension was present in 103 AS patients (41%) versus 31% in the general population (p = 0.026). Hypercholesterolemia was present in 30 patients (12%). The results for hypertension, hypercholesterolemia and overweight are displayed categorized by age and gender in Figure 1. Compared to the general Dutch population, the prevalences of hypertension and smoking are higher in AS patients, the latter, however, only in AS males.Figure 1


Cardiovascular risk management in patients with active ankylosing spondylitis: a detailed evaluation.

Heslinga SC, Van den Oever IA, Van Sijl AM, Peters MJ, Van der Horst-Bruinsma IE, Smulders YM, Nurmohamed MT - BMC Musculoskelet Disord (2015)

Prevalences of hypertension (A), overweight (B) and hypercholesterolemia (C) in AS patients compared to the general Dutch population in four different age categories. Legend: X-axis: age categories, Y-axis: percentage, black: ankylosing spondylitis population, grey: general Dutch population.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4404047&req=5

Fig1: Prevalences of hypertension (A), overweight (B) and hypercholesterolemia (C) in AS patients compared to the general Dutch population in four different age categories. Legend: X-axis: age categories, Y-axis: percentage, black: ankylosing spondylitis population, grey: general Dutch population.
Mentions: Of 254 AS patients, eight patients (3%) had a history of CVD and five patients (2%) were diagnosed with type 2 DM. One-hundred-and-nine patients (43%) smoked (45% of the men and 38% of the women) compared to 27% of the general Dutch population (30% of the men and 24% of the women) p = 0.001. Mean BMI was 26.2 ± 4.6, 134 patients (53%) were overweight and 44 patients (17%) were obese. Hypertension was present in 103 AS patients (41%) versus 31% in the general population (p = 0.026). Hypercholesterolemia was present in 30 patients (12%). The results for hypertension, hypercholesterolemia and overweight are displayed categorized by age and gender in Figure 1. Compared to the general Dutch population, the prevalences of hypertension and smoking are higher in AS patients, the latter, however, only in AS males.Figure 1

Bottom Line: CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients.The prevalences of hypertension (41% vs 31%) and smoking (43% vs 27%) were substantially higher in AS patients as compared to the general Dutch background population.Although the majority of all AS patients eligible for CV-RM received CV risk medication, CV-RM remains a challenge for treating physicians, as treatment targets were not achieved in three-quarter of the eligible patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Reade, Amsterdam, Netherlands. s.heslinga@reade.nl.

ABSTRACT

Background: Ankylosing spondylitis (AS) is an inflammatory disease with documented elevated cardiovascular (CV) risk due to systemic inflammation and a higher prevalence of CV risk factors. CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients. We assessed CV risk and evaluated guideline adherence according to the Dutch CV-RM guideline.

Methods: This study was conducted with a cohort of consecutive AS patients eligible for treatment with a tumor necrosis factor (TNF) -α inhibitor. Data from the Dutch National Institute for Public Health and Environment was used to compare the prevalence of CV risk factors in AS patients with the Dutch background population.

Results: In total, 254 consecutive AS patients were included. The prevalences of hypertension (41% vs 31%) and smoking (43% vs 27%) were substantially higher in AS patients as compared to the general Dutch background population. Of 138 AS patients older than 40 years the 10-years CV risk could be calculated. Fifty-one of these 138 patients (37%) had an indication for CV risk treatment. CV risk treatment was initiated in 42 of the 51 (82%), however, in only 12 of the 51 (24%) patients treatment targets for either hypertension or hypercholesterolemia were reached.

Conclusion: The increased rates of hypertension and smoking illustrate the importance of CV-RM in AS patients. Although the majority of all AS patients eligible for CV-RM received CV risk medication, CV-RM remains a challenge for treating physicians, as treatment targets were not achieved in three-quarter of the eligible patients.

No MeSH data available.


Related in: MedlinePlus