Increasingly, diseases once thought disparate in nature are being linked together by the common root of chronic inflammation. Not long ago, an inflammatory joint condition like rheumatoid arthritis (RA) was thought to have little to no impact on the risk of developing cardiovascular disease like heart attack or stroke. But continuously such subtle relationships are being exposed and defined.
Recently RA has been shown to increase the risk of atherosclerotic cardiovascular event rates to a similar extent as type 2 diabetes; independent of other risk factors. It has also been demonstrated, particularly in younger affected individuals that the risk of atherosclerotic disease like carotid artery plaque correlates with the severity of the RA.
A recent study evaluated women with rheumatoid arthritis who by traditional risk assessment had a very low likelihood of any significant underlying cardiovascular disease. None of the women had any known cardiovascular disease, moderate or severe kidney disease or diabetes. They were screened for the presence of blockages in the carotid artery.
The results were shocking. Approximately one in four of these women deemed at low risk actually had significant atherosclerotic burden suggesting that they were in reality at very high risk for events like heart attacks and strokes.
In The Fallacy of the Calorie: Why the Modern Western Diet Is Killing Us and How to Stop It, I discuss the link between the modern Western diet and the risk of developing such disabilities and diseases associated with such a hyper-immune response. In concert with our genetic background the foods we choose to eat-mediated by our gut microbiome-can hold the key to health and wellness or disability and disease.
The Fallacy of The Calorie (read more here)
Corrales, A., Dessein, P. H., Tsang, L., Pina, T., Blanco, R., Gonzalez-Juanatey, C., . . . Gonzalez-Gay, M. A. (2015). Carotid artery plaque in women with rheumatoid arthritis and low estimated cardiovascular disease risk: a cross-sectional study. Arthritis Research & Therapy, 17:55 doi:10.1186/s13075-015-0576-7.
del Rincon, I., Freeman, G., Haas, R., O’Leary, D., & Escalante, A. ( 2005). Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical manifestations to atherosclerosis. Arthritis Rheum., 52:3413–23.
Peters, M., Symmons, D., McCarey, D., Dijkmans, B., Nicola, P., & Kvien, T. (2010). EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis, 69:325–31.