Why is CV risk elevated in RA?

RA accelerates atherosclerosis through chronic systemic inflammation, dyslipidemia (low HDL, high triglycerides), endothelial dysfunction, and physical inactivity. Cardiovascular disease accounts for 40-50% of excess mortality in RA.

What is the EULAR 1.5× multiplier for RA CV risk?

Apply 1.5× multiplication if ≥2 of: RA duration >10 years, seropositivity (RF or anti-CCP+), or extra-articular manifestations. This adjustment reflects the incremental CV risk from chronic RA beyond traditional risk factors.

Do RA treatments affect cardiovascular risk?

Effective RA treatment reduces CV risk. Methotrexate (30% CV event reduction), hydroxychloroquine, and statins are cardioprotective. TNFi and IL-6Ri reduce CV risk in active RA. JAKi (tofacitinib) raised CV concerns in ORAL Surveillance but risk appears driven by underlying patient factors.

Cardiovascular Risk Adjustment for Rheumatoid Arthritis (EULAR)

Apply EULAR-recommended cardiovascular risk adjustment for rheumatoid arthritis. Multiply SCORE or Framingham risk by 1.5× if RA criteria met (disease duration >10 years, RF/anti-CCP positive, extra-articular disease). Guides statin initiation.

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Frequently Asked Questions

Why is CV risk elevated in RA?

What is the EULAR 1.5× multiplier for RA CV risk?

Do RA treatments affect cardiovascular risk?