If you’ve recently been diagnosed with rheumatoid arthritis (RA), starting treatment as soon as possible can help protect your swollen, achy joints—and your heart.
People with RA have nearly double the risk of developing heart disease as those who don’t have RA, according to the Arthritis Foundation. The risk of heart attack and stroke is also higher. In fact, the most common cause of death for people with RA are diseases of the heart and blood vessels.
The link between RA and heart disease
There are two main reasons people with RA are more prone to heart disease. The first is inflammation. In RA, small proteins called cytokines become inflamed and damage joints. They also cause a sticky substance called plaque to form in blood vessels. This can lead to a heart attack or stroke.
The second reason is that RA itself is a risk factor for other issues that can lead to heart disease. These include:
- High blood pressure: Many people with RA find it harder to exercise with painful joints, and a lack of activity can contribute to high blood pressure. RA treatments can contribute, as well. The elasticity of arteries is also affected by RA, which can constrict blood flow and raise blood pressure.
- Lipid imbalances: Lipids, including fats and cholesterol in the blood, are often imbalanced in people with RA. These imbalances are linked to heart disease.
- Obesity: Lack of physical activity also can contribute to weight gain. Obesity is a factor in body-wide inflammation and tied to many heart and blood vessel problems.
- Metabolic syndrome: This encompasses several conditions, including high blood sugar, obesity, high cholesterol, and high blood pressure.
- Smoking: Smoking damages blood vessels. People with RA who smoke have a 50 percent higher risk of serious heart issues than people with RA who don’t smoke.
What you can do
Heart deaths related to RA have dropped significantly over the years. One big reason is improved treatments. Many people with RA take medications that address inflammation at its source, rather than just relieve pain. These drugs, known as disease-modifying antirheumatic drugs (DMARDs), are usually the core of RA treatment, because they prevent or reduce joint damage. They include traditional DMARDs like methotrexate, sulfasalazine, and hydroxychloroquine, and newer drugs known as biologics.
That’s why the best step you can take towards treating RA and lowering your risk of heart issues is visiting a healthcare provider (HCP). An HCP can create a treatment plan and prescribe medications. The earlier you start taking them, the more effective they’re likely to be.
Adopting a heart-healthy lifestyle is also key for people with RA. Here are a few ways to take control of your health.
- Be active: Exercise is good for your joints and blood vessels and can help ease inflammation. Aim to do both aerobic and strengthening exercises. Talk to an HCP about activities that would work best with your RA.
- Choose healthy foods: Eat plenty of fruits and vegetables, whole grains, nuts, seeds, legumes, and lean proteins like chicken breast or fish. Limit or avoid saturated fats and trans fats, as they can contribute to weight gain and harm your heart.
- Tackle stress: Stress can worsen RA symptoms. Look for meditation or other relaxation techniques to help you relax, both in the moment and over the long term.
- Quit smoking: If you smoke, talk with your HCP about tools and resources to help you kick the habit.
- Monitor yourself: Track your blood pressure, cholesterol, and blood sugar so you can detect changes and take steps to address issues. Talk with an HCP about checking in regularly on other measurements of your heart health, too.
- Look at your medications: Work with your HCP to limit use of nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids. These drugs are often needed for RA flare-ups or while DMARDs are being adjusted, but they may contribute to heart risk.
By taking an active role in your self-care and arranging prompt treatment with your HCP, you can significantly reduce your risk of RA-related heart problems.
Sources: Arthritis Foundation. Rheumatoid Arthrit... + 6
- Arthritis Foundation. Rheumatoid Arthritis and Heart Disease. Page last updated February 11, 2022.
- Figus FA, Piga M, et al. Rheumatoid arthritis: Extra-articular manifestations and comorbidities. Autoimmun Rev. 2021;20(4):102776.
- Mantel Ä, Holmqvist M, et al. Association Between Rheumatoid Arthritis and Risk of Ischemic and Nonischemic Heart Failure. J Am Coll Cardiol. 2017;69(10):1275-1285.
- Myasoedova E, Davis JM, et al. Improved Incidence of Cardiovascular Disease in Patients With Incident Rheumatoid Arthritis in the 2000s: A Population-based Cohort Study. J Rheumatol. 2021;48(9):1379-1387.
- Ahmad M, Shehzad D, et al. Trends in rheumatoid arthritis associated cardiovascular mortality in the United States from 1999 to 2020. Curr Probl Cardiol. 2024;49(7):102607.
- Cleveland Clinic. Disease-Modifying Antirheumatic Drugs (DMARDS). Page last reviewed April 7, 2022.
- Arthritis Foundation. Best Stress Relievers for Arthritis. Page accessed October 29, 2024.
