Rheumatoid arthritis increases fatal blood clot risk

Rheumatoid arthritis greatly increases the risk of potentially fatal blood clots, despite not being considered a traditional risk factor, a study suggests.

Patients with rheumatoid arthritis more often had hypertension
Patients with rheumatoid arthritis more often had hypertension

Patients with the joint disorder were more than three times as likely to develop DVT and twice as likely to develop pulmonary embolism as those without the condition.

Researchers said changes in blood flow and coagulation caused by chronic inflammation may be behind the raised risk.

Writing in the Annals of the Rheumatic Diseases, they said the findings highlighted the importance of multidisciplinary care for these patients.

DVT and pulmonary embolism kill 11-30% of people within 30 days, but rheumatoid arthritis is not usually considered a risk factor for these conditions.

Researchers in Taiwan tracked 29,238 people with rheumatoid arthritis in the country between 1998 and 2010 using data from a national insurance scheme. The average age at diagnosis was 52 years, and three-quarters were women.

These patients were matched to 116,952 healthy people of similar age and sex.

There were 463 cases of DVT and 209 cases of pulmonary embolism in this time.

Patients with rheumatoid arthritis more often had hypertension, diabetes, high cholesterol, heart failure and fractures than the healthy controls.

However, even after accounting for these factors, researchers found rheumatoid arthritis patients had a 3.4-fold higher risk of DVT and a 2.1-fold greater chance of pulmonary embolism.

Patients under 50 years were almost six times as likely to develop DVT and three times as likely to develop pulmonary embolism than those who were middle aged or older.

Study authors said: ‘These findings highlight the importance of a multidisciplinary team adopting an integrated approach to the intervention of potential risk factors among patients with rheumatoid arthritis.

‘Future research concerning rheumatoid arthritis severity scale, such as disease activity, functional impairment and physical damage, are warranted.’

Ann Rheum Dis Online 2013

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