More than half of adults with heart disease also had arthritis, and they were 30% more likely to be physically inactive than were those with heart disease alone, judging from the findings of a survey of 757,959 Americans.
The Centers for Disease Control and Prevention analyzed data from all 50 states in the 2005 and 2007 Behavioral Risk Factor Surveillance System. In telephone interviews, 3% of respondents said they had been diagnosed with heart disease alone, 23% reported a diagnosis of arthritis alone, 4% said they had both, and 70% had neither.
Arthritis—defined as arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia—was present in 57% of the respondents with heart disease, compared with 27% of the total population (MMWR 2009;58:165-9).
In an interview, rheumatologist John A. Goldman, who was not involved with this study, said that getting patients with joint pain to increase activity is a priority for his colleagues who treat arthritis. “The CDC's recent slogan is 'Exercise, the Arthritis Pain Reliever.' Exercise is necessary. Working with physical therapists—especially trainers—on weight reduction; nonimpact, loading exercises; [and] bracing” can all help, said Dr. Goldman, who has a private rheumatology practice in Atlanta.
The investigators asked six questions about the frequency and duration of nonoccupational activities of moderate and vigorous activity; respondents who reported no participation in such activities were considered to be inactive.
People with heart disease and arthritis had the highest rate of inactivity (29%) compared with rates of 21% in people with heart disease alone, 18% in people with arthritis alone, and 11% in those who had neither heart disease nor arthritis, according to the MMWR report.
After adjustment for the effects of age, sex, education level, body mass index, and race or ethnicity, inactivity was 30% more likely in those with heart disease and arthritis, compared with people who had heart disease alone.
The risk of having one or both conditions increased with age. Men had a higher prevalence of heart disease alone (4%) or heart disease plus arthritis (4%) compared with women (2% and 3.5%, respectively). Women were more likely to have arthritis alone (27%) compared with men (19%). Whites were more likely than blacks to have one or both conditions. Each of these comparisons between subgroups was statistically significant.
According to Dr. Goldman, treating arthritis patients who are at risk for heart disease requires coordination with the patient's cardiologist and/or primary care physician. The use of anti-inflammatory disease-modifying antirheumatic drugs and also biologic therapies like methotrexate and tumor necrosis factor-alpha inhibitors decrease the risk of vascular disease, as do traditional cardiovascular drugs like statins, he said. Thus, treatment of both the RA and other inflammatory diseases, and also treatment for lipids, blood pressure, and diabetes mellitus need to be done in concert, he noted.
Associate Editor Denise Napoli contributed to this article.
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