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Rheumatoid Arthritis May Raise Risk of Blood Vessel Plaque
Date:11/8/2010

irst test was done at the start of the study, and the second was done an average of about three years later.

About two-thirds of the study participants were female, and their average age was 59 years at the beginning of the study.

The researchers measured the thickness of the common carotid artery and the internal carotid artery. The carotid arteries provide crucial blood flow to the brain.

In between scans, 82 percent of people had some thickening in their common carotid artery, while 70 percent had thickening in the internal carotid artery, according to the study.

People who were treated with TNF-inhibiting medications, such as infliximab (Remicade) or adalimumab (Humira), had a 37 percent lower rate of thickening in their common carotid artery compared to people not on the medication.

However, not all medications were helpful. Those taking corticosteroids, such as prednisone, had an increased risk of carotid thickening, unless they were also taking a cholesterol-lowering medication known as a statin. Statin use seemed to counter the negative effect of the steroid, according to the study.

High levels of inflammation in the body were associated with increased plaque deposits, Giles noted.

"These are slowly progressive changes. It's not as if these plaques are limiting blood flow; they're more subtle changes, but by attenuating risk factors, and potentially intervening early on, we may be able to make a difference," Giles said.

Dr. Nadera Sweiss, a rheumatologist with the University of Chicago Medical Center, said the study supports the concept of inflammation and its relationship to atherosclerosis.

"But it's not clear how we can change the outcome yet," she said.

"I think this study will push all of us to think more about modifiable risk factors when we see patients with rheumatoid arthritis," said Sweiss. "If someone is overweight, I may pay more attention and refer to a dietitian earlier on, or
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