Risk of Cardiovascular Disease in Patients With Osteoarthritis: A Prospective Longitudinal Study
Article first published online: 27 NOV 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 12, pages 1951–1958, December 2013
How to Cite
Rahman, M. M., Kopec, J. A., Anis, A. H., Cibere, J. and Goldsmith, C. H. (2013), Risk of Cardiovascular Disease in Patients With Osteoarthritis: A Prospective Longitudinal Study. Arthritis Care Res, 65: 1951–1958. doi: 10.1002/acr.22092
- Issue published online: 27 NOV 2013
- Article first published online: 27 NOV 2013
- Accepted manuscript online: 7 AUG 2013 12:44PM EST
- Manuscript Accepted: 17 JUL 2013
- Manuscript Received: 31 JAN 2013
- Graduate training award from the Canadian Arthritis Network/The Arthritis Society
- Doctoral training award from the Canadian Institutes of Health Research
To determine the risk of cardiovascular disease (CVD) among osteoarthritis (OA) patients using population-based administrative data from British Columbia, Canada.
The medical history of a random sample of 600,000 individuals from 1991–2009 was analyzed. A total of 12,745 OA cases and up to 3 non-OA individuals matched by age, sex, and year of diagnosis were followed for CVD events. Cox proportional hazards and Poisson regression models were used to estimate the relative risks (RRs) of CVD, myocardial infarction, ischemic heart disease (IHD), congestive heart failure (CHF), and stroke after adjusting for available sociodemographic and medical factors.
OA was an independent predictor of CVD. The adjusted RRs were 1.15 (95% confidence interval [95% CI] 1.04–1.27), 1.26 (95% CI 1.13–1.42), and 1.17 (95% CI 1.07–1.26) among older men, younger women, and older women, respectively. Analyses were stratified by age and sex due to statistically significant interactions between OA and age and sex. RRs among older men, younger women, and older women were 1.33 (95% CI 1.11–1.62), 1.66 (95% CI 1.37–2.01), and 1.45 (95% CI 1.22–1.72) for IHD, respectively, and 1.25 (95% CI 1.02–1.54), 1.29 (95% CI 1.00–1.68), and 1.20 (95% CI 1.03–1.39) for CHF, respectively. Compared to non-OA individuals, OA cases who underwent total joint replacements had a 26% increased risk of CVD.
This prospective longitudinal study suggests that OA is associated with an increased risk of CVD. Older men and adult women with OA had a higher risk of CVD, particularly IHD and CHF. Further studies are needed to confirm these results and to elucidate the potential biologic mechanisms.