Heart Disease, Not MS

MS is such a bizarre disease which affects the body in many different ways because it disrupts the central nervous system (CNS) which is the headquarters of the body’s electrical system.  Sabotage the electrical impulses traveling to and from the brain and it’s hard to predict just what might happen.

Let me tell you about two MS friends.  Each had a heart attack, but only one had a positive outcome.  The first friend, Laura, shares that she had a heart attack and was fortunate enough to get help quickly and suffer little heart damage.  She says, “dumb luck and listening to the voices that told me something was wrong sent me to the ER before my heart attack happened and it occurred in the hospital while I was already hooked up to nitroglycerin.”


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Listening to your inner voice: When it isn't MS but Heart Disease

RA and Congestive Heart Failure

What is the risk of Congestive Heart Failure in patients with RA?

Researchers at the Mayo Clinic have observed that patients with RA have twice the risk of developing congestive heart failure as compared with persons without rheumatoid arthritis. The excess risk stayed elevated even after researchers adjusted for common cardiovascular risk factors (i.e., hypertension, smoking, diabetes) and ischemic heart disease. Most interesting is that the risk of congestive heart failure is higher in RA patients who are RF-positive than in those who are RF-seronegative. This increased risk may be present at the earliest stages of the disease and may occur in the absence of obvious cardiovascular risk factors or ischemic heart disease. See “The Risk of Congestive Heart Failure in Rheumatoid Arthritis: A Population-Based Study Over 46 Years.”

In a more recent study, the Mayo Clinic researchers found that RA patients with heart failure appear to have a more subtle presentation, with a lower frequency of typical heart failure symptoms and signs, as compared with non-RA patients with heart failure. Mortality in the first year following heart failure is also higher in RA patients. Their data suggests that new ways of screening for early left ventricular dysfunction in patients with RA should be investigated in order to optimize survival rates. See “The Presentation and Outcome of Heart Failure in Patients With Rheumatoid Arthritis Differs From That in the General Population.”

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Rheumatoid Arthritis and Congestive Heart Failure

RA and Heart Disease

What does cardiovascular disease look like in rheumatoid arthritis?

The chronic inflammation which damages joints also takes its toll on the heart and arteries. The doctors at Johns Hopkins provide a summary of recent studies focused on RA and heart disease. Compared to the general population, rheumatoid arthritis patients have a significantly increased risk of heart attack and stroke and a shorter life expectancy.

• Heart attacks are twice as common among women with rheumatoid arthritis as among those without the disease.

• Atherosclerosis ("hardening of the arteries”) starts early and progresses more rapidly in people with rheumatoid arthritis.

• Carotid artery blockages (a risk factor for stroke) are three times more common in people with rheumatoid arthritis than in people without the disease (44% vs. 15%).

• Cardiovascular events, such as heart attack and stroke, occur about 10 years earlier in people with rheumatoid arthritis.

• Mortality is higher among rheumatoid arthritis patients after a first heart attack.

• Blood vessel damage is often already apparent at the time of rheumatoid arthritis diagnosis.

• Heart attacks in rheumatoid arthritis patients are more likely to be silent or to occur without the typical symptoms, and they more often result in sudden cardiac death.

• Congestive heart failure (weakening of the heart’s pumping ability) is more common among people with rheumatoid arthritis.

Accumulating immune system cells (caused by chronic inflammation) attract deposits of cholesterol, blood platelets, cellular debris, and calcium, which clump together to form plaque. As plaque deposits grow, they restrict blood flow through the artery. If the plaque ruptures, clots can break away and travel to the heart or brain, where they may cause a heart attack or a stroke.

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Rheumatoid Arthritis and Cardiovascular Disease