RA and heart disease

JenHB

Hi,

Was having an annual review with the GP (by phone) and they throw in the curved ball of 'you have increased risk of heart disease as you have rheumatoid arthritis but the methotrexate will help with that too'. This was the first I've heard of that.... He then asked if I'm doing exercise to raise the heart rate (which I am - I'm easing slowly back into parkrun and gradually increasing the amount of running). [All my bloods are normal]

I'm assuming it's probably more people with RA tend to be less active (and therefore maybe overweight) which leads to higher risk of heart disease rather than the RA directly. Is this a fair assumption?

jamieA

Hi @JenHB

I was diagnosed with psoriatic arthritis in late October 2020 and in late May 2021 I was admitted to hospital with atrial fibrillation and tachycardia. Prior to this I had no history of heart problems. At the time I was on 3gms of sulfasalazine and 20mgs MTX. I had also previously been on 4 months of prednisolone and had had about 10 kenalog steroid injections over the previous 7 months. I was also taking NSAIDS and amitriptylene at the time which were stopped immediately the heart issue occured. I took another episode of tachycardia in Oct. 2021, was admitted to hospital and my MTX was reduced to 10mgs that night. I've not had another episode since. I'm not particularly overweight and I was fairly active before the PsA appeared - walking 60-70kms a week including hill walking.

I know the internet can be a bit of a wild west for theories but there are a number of legitimate medical publications that have separately linked inflammatory arthritis, steroids, opiate painkillers, NSAIDS and MTX to heart issues.

I saw a cardiologist in November 2022 and his take on it was that since they think I had had covid in March 2020 that was the likely cause of the heart issues though he could not explain why I haven't had any further issues since they halved my MTX. He also said my risk of a stroke is 5 times greater now than before despite the fact that multiple ECGs have come back showing no issues.

movingslowly

@JenHB

I'm led to believe your assumptions to be some of the contributing factors 🙂

The NHS site has information on the Complications of R.A

Baloo

@JenB Raising my heart rate isn't even on the agenda. Pfft. My heart rate is around 80 while doing nothing anyway. I had pretty much gained the impression that Arthritis and aerobic exercise are going to be incompatible. I will certainly think about getting some though. My idea of aerobic at the moment is a brisk shuffle up the hill to work, or a long shuffly walk until my feet hurt. At a stretch I might be persuaded to get the bicycle out or hit the gym. Right now its +1C and there is no way I am going outside.

stickywicket

This might help explain it. https://creakyjoints.org/living-with-arthritis/complications/rheumatoid-arthritis-heart-disease-increased-risk/

Woofy

Gawd.

Baloo

The risk of heart disease looks real enough to produce a heart attack from just reading about it. This week, work has finally given us a wellbeing hour (about time too) so I'm already booked into the gym Friday morning during my first Wellbeing Hour for a personal trainer session with Nuffield. We are going to look at how much bicycle or rowing I can safely do with stiff knees to get some aerobic exercise. I believe they will do a proper measurement of vitals at the same time. The most dramatic change has been heart rate up, and it could use coming down again.