3 Citations (Scopus)

Abstract

Background: Only a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. Methods: Data regarding 52,840 subjects (10,568 patients with RA and 42,272 age-, sex-, urbanization-, and income-matched non-RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. Results: RA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95% confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35-fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95% CI, 7.22–11.41) relative to subjects without RA and hypertension. Conclusion: RA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.

Original languageEnglish
JournalJournal of the Chinese Medical Association
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Cerebrovascular Disorders
Coronary Artery Disease
Young Adult
Rheumatoid Arthritis
Hypertension
Confidence Intervals
Urbanization
National Health Programs
Proportional Hazards Models
Arthritis
Comorbidity

Keywords

  • Cerebrovascular disorders
  • Coronary artery disease
  • Hypertension
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{1d9d4953b1e442bea052993a1f7e6642,
title = "The effect of rheumatoid arthritis on the risk of cerebrovascular disease and coronary artery disease in young adults",
abstract = "Background: Only a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. Methods: Data regarding 52,840 subjects (10,568 patients with RA and 42,272 age-, sex-, urbanization-, and income-matched non-RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. Results: RA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95{\%} confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35-fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95{\%} CI, 7.22–11.41) relative to subjects without RA and hypertension. Conclusion: RA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.",
keywords = "Cerebrovascular disorders, Coronary artery disease, Hypertension, Rheumatoid arthritis",
author = "Chen, {Yih Ru} and Hsieh, {Fang I.} and Chang, {Chi Ching} and Chi, {Nai Fang} and Wu, {Hsin Chiao} and Chiou, {Hung Yi}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jcma.2018.03.009",
language = "English",
journal = "Journal of the Chinese Medical Association",
issn = "1726-4901",
publisher = "Elsevier Taiwan LLC",

}

TY - JOUR

T1 - The effect of rheumatoid arthritis on the risk of cerebrovascular disease and coronary artery disease in young adults

AU - Chen, Yih Ru

AU - Hsieh, Fang I.

AU - Chang, Chi Ching

AU - Chi, Nai Fang

AU - Wu, Hsin Chiao

AU - Chiou, Hung Yi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Only a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. Methods: Data regarding 52,840 subjects (10,568 patients with RA and 42,272 age-, sex-, urbanization-, and income-matched non-RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. Results: RA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95% confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35-fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95% CI, 7.22–11.41) relative to subjects without RA and hypertension. Conclusion: RA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.

AB - Background: Only a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. Methods: Data regarding 52,840 subjects (10,568 patients with RA and 42,272 age-, sex-, urbanization-, and income-matched non-RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. Results: RA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95% confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35-fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95% CI, 7.22–11.41) relative to subjects without RA and hypertension. Conclusion: RA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.

KW - Cerebrovascular disorders

KW - Coronary artery disease

KW - Hypertension

KW - Rheumatoid arthritis

UR - http://www.scopus.com/inward/record.url?scp=85048561467&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048561467&partnerID=8YFLogxK

U2 - 10.1016/j.jcma.2018.03.009

DO - 10.1016/j.jcma.2018.03.009

M3 - Article

AN - SCOPUS:85048561467

JO - Journal of the Chinese Medical Association

JF - Journal of the Chinese Medical Association

SN - 1726-4901

ER -