Cardiovascular deaths accounted for about half of the deaths for rheumatoid arthritis patients in the research sample. The findings did not distinguish between the types of cardiovascular disease that led to mortality. An earlier Mayo study confirmed a strong link between rheumatoid arthritis and congestive heart failure, however.
"It is possible that the cardiovascular interventions that improved life expectancy in the general population may not have had the same beneficial effects in patients with rheumatoid arthritis," Gabriel said.
The research did not study the causes of mortality, added Gabriel. She speculates, however, that since inflammation is thought to be a risk factor for cardiovascular disease, patients with rheumatoid arthritis represent a higher risk group, because their illness involves active, systemic inflammation.
The study was expected be published in the November issue of the Journal of Arthritis & Rheumatism.
The results are a powerful reminder that rheumatoid arthritis is a "very important and deadly disease," said Dr. Hayes Wilson, a medical adviser to the Arthritis Foundation.
"It's not just 'take two aspirin and call me in the morning,' " he said. "Get an early diagnosis and treat it aggressively. The consequence of not treating it aggressively could be excess mortality," Wilson said.
"We need to find out why it's killing people," added Wilson, who is also chief of rheumatology at Piedmont Hospital in Atlanta.
Dr. Stephen Lindsey, chief of rheumatology at Ochsner Health Systems in Baton Rouge, La., noted that while the study does not cover the impact of the latest medications, other new drugs did become available in the '80s and '90s. However, they apparently did not improve mortality, he said.
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