Carotid Atherosclerosis and Cardiovascular Risk Factors in Patients With Rheumatoid Arthritis at Kenyatta National Hospital
Abstract
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with
increased cardiovascular disease. The purpose of my study was to determine the prevalence
of carotid atherosclerosis and selected cardiovascular risk factors namely: hypertension,
diabetes, obesity, dyslipidaemia and smoking among patients with RA at the Outpatient
Rheumatoid clinic in Kenyatta National Hospital.
Methodology: This was a cross-sectional descriptive study with a comparative arm,
undertaken at the Kenyatta National Hospital, Rheumatology clinic. Study subjects with
RA were patients who satisfied the ACR/EULAR 2010 criteria and above the age of 18
years. Comparative arm comprised of age and sex matched individuals without RA. History
of medications used, diabetes, hypertension and cigarette smoking were obtained. Bilateral
carotid Doppler ultrasounds, blood pressure, weight and height were recorded. Drawing of
blood was done from each participant to measure the non-fasting total cholesterol and blood
sugar level. The outcomes of interest were prevalence of carotid atherosclerosis as defined
as Carotid intima-medial thickness, CIMT, of more than 0.9 mm or carotid plaque, CIMT
of more than 1.5 mm and the prevalence of cardiovascular risk factors. Data was analysed
by use of SPSS version 21, p value <0.05 considered as significant.
Results: 78 RA subjects were randomly selected of which 8 were excluded. 73 controls
were recruited, giving a total of 143 participants. Of all the study participants, not even one
had a previous history of cardiovascular event. The prevalence of subclinical carotid
atherosclerosis among RA patients was 28.6% Vs 13.7% in those with no RA (p = 0.029).
The prevalence of hypertension was 30% in RA Vs 35.6% in those with no RA (p=0.475),
Diabetes 4.3% in RA Vs 11.0% in those with no RA (p=0.134). Prevalence of
dyslipidaemia was 21.4% among those with RA and 13.7% among those with no RA
(p=0.224). The prevalence of abnormal BMI (>25) was 58.6% among those with RA and
75.3% among those with no RA (p=0.033).
Conclusion: Almost one in every three RA patients had subclinical atherosclerosis. RA
patients were more prone to dyslipidaemia than those with no RA.
Recommendation: Subclinical atherosclerosis and dyslipidaemia is common in RA and
the clinicians should be alert and intervene early to prevent cardiovascular diseases.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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