Arthritis is often associated with joint pain, fatigue and reduced mobility. But there are some lesser-known side effects that could have a tremendous impact on your body.
For example, did you know arthritis could increase risks of cardiovascular events such as heart attacks, strokes, heart failure, and even death?
"The 'whole body' nature of arthritis highlights the importance of recognizing and managing its potential impact on your heart health," says Dr. Bindee Kuriya, rheumatologist at Sinai Health System, and Assistant Professor at the University of Toronto. "Chronic inflammation, a characteristic of arthritis, can damage the lining of blood vessels1, leading to plaque build-up, clots, and narrowing of the arteries," says Dr. Kuriya. "In turn, this can reduce blood flow to organs like the heart or brain, which can lead to heart attacks or strokes, respectively".
Simply put, inflammation is a key component of the development and progression of heart disease.
And beyond that, traditional risk factors like high blood pressure, high cholesterol levels, high blood sugar, and being overweight or obese — risk factors that are much more common in people living with arthritis — play a significant role in elevating cardiovascular risk.
"Identifying and addressing these risk factors, in addition to limiting inflammation, is crucial to managing your cardiovascular risk," says Dr. Kuriya.
The effects of arthritis medications
Disease-modifying antirheumatic drugs (DMARDs) and biologic agents, commonly used to manage inflammatory arthritis, have been associated with a reduced risk of cardiovascular events due to their anti-inflammatory effects.
However, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids, commonly used for arthritis symptom management, may elevate cardiovascular risk and should be used at the lowest dose and for the shortest time possible to control your symptoms.
This highlights the importance of having a clear line of communication with your healthcare provider, including your pharmacist, when discussing your medication options. Your team will implement a treatment plan that take your general health into consideration, not just your arthritis.
Six tips to reduce the risks
There isn't one singular, direct action to take to prevent risks of cardiovascular complications, but rather a list of healthy habits you can adopt. Doing so can improve your condition and your odds of keeping the risks at bay.
1. Exercise regularly: Painful joints can make it hard to exercise, but even low impact activities such as walking, swimming, and bicycling are beneficial.
2. Eat well: Keeping a healthy weight and eating well can decrease the risks of high blood pressure, diabetes and obesity. Planning meals ahead and considering anti-inflammatory recipes could go a long way.
3. Limit stress: Feeling overwhelmed and under pressure can spark a negative physiological response. It's important to apply stress-managing strategies like mindfulness meditation or yoga.
4. Go smoke-free: Smoking has been linked to worse arthritis symptoms2 and joint damage and can increase your risk of heart disease by as much as 50%. If quitting is hard, many pharmacies offer support programs and monitoring. Ask your pharmacist how they can help.
5. Keep tabs: "Speak to your healthcare provider about regular screening — ideally once a year — for high blood pressure, diabetes, and cholesterol levels. If elevated, there are many effective lifestyle interventions and medications to treat these and lower your risk of heart complications," says Dr. Kuriya.
6. Manage symptoms: Good control of your arthritis and inflammation with ongoing management and monitoring by your healthcare provider is paramount to keep your heart healthy.
For more tips on multifaceted arthritis symptom management, consult our useful online learning modules.
1. Mason JC, Libby P. Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions. Eur Heart J. 2015 Feb 21;36(8):482-9c. doi: 10.1093/eurheartj/ehu403. Epub 2014 Nov 27. PMID: 25433021; PMCID: PMC4340364.'
2. Wieczorek M, Gwinnutt JM, Ransay-Colle M, Balanescu A, Bischoff-Ferrari H, Boonen A, Cavalli G, de Souza S, de Thurah A, Dorner TE, Moe RH, Putrik P, Rodríguez-Carrio J, Silva-Fernández L, Stamm TA, Walker-Bone K, Welling J, Zlatkovic-Svenda M, Verstappen SM, Guillemin F. Smoking, alcohol consumption and disease-specific outcomes in rheumatic and musculoskeletal diseases (RMDs): systematic reviews informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open. 2022 Mar;8(1):e002170. doi: 10.1136/rmdopen-2021-002170. PMID: 35351808; PMCID: PMC8966569.
Banks, E., Joshy, G., Korda, R.J. et al. Tobacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study. BMC Med 17, 128 (2019). https://doi.org/10.1186/s12916-019-1351-4
US Dept of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1989. DHHS Publication (CDC) 89-8411.