Rheumatoid Arthritis Patients at Increased Risk of Stroke

UK physicians have reviewed the medical data on more than 33,000 patients with rheumatoid arthritis, and made an interesting discovery. Their findings were reported at the recent American College of Rheumatology meeting.

The frequency of stroke was analyzed in the rheumatoid arthritis patients and in approximately 100,000 patients without the disease; each rheumatoid patient was matched with 3 control patients with respect to age, gender, and medical practice. The stroke count included both ischemic and hemorrhagic strokes. Over a 15-year period, there were 880 stroke cases among the rheumatoid patients, which was about 65% higher than expected, based on data from the controls. Taking corticosteroid medication for their rheumatism was associated with a reduced stroke frequency, but it was still about 30% higher than in non-steroid users.

If the patients were taking so-called ‘disease-modifying antirheumatic drugs’ (DMARDs) there wasn’t a significant effect, although there was a slightly increased risk in those taking methotrexate.

This study shows that rheumatoid arthritis must be added to the list of risk factors for stroke. The reduction in frequency in patients taking steroids (which are anti-inflammatory) helps explain the likely relationship between inflammation and stroke. Until a better intervention is uncovered, it makes sense to treat rheumatoid arthritis aggressively in order to reduce the level of inflammatory markers, such as sedimentation rate and rheumatoid factor.