Depression, stress and anxiety could be key to increased heart disease in rheumatoid arthritis

Depressive symptoms, stress, anxiety, anger and lack of social support in people with rheumatoid arthritis may be link to atherosclerosis (the build-up of fatty deposits in the arteries that contributes to cardiovascular disease), experts claim in Arthritis Care & Research. Screening and treatment of psychosocial symptoms may therefore improve cardiovascular health of this group of people.

We already know that people with rheumatoid arthritis are at greater risk of cardiovascular disease than health people but it hasn’t been clear why.

So scientists looked at the risk factors for cardiovascular disease in 195 people with rheumatoid arthritis and compared them to 1,073 controls. The volunteers had scans and ultrasound to measure coronary artery calcium (CAC) and plaque in the carotid artery to work out how much atherosclerosis there was.

Higher scores of anxiety, anger, depression and caregiver stress were associated with higher risk of CAC greater than 100 units (meaning moderate to severe disease) in people with rheumatoid arthritis. And people with rheumatoid arthritis had an increased risk of carotid plaque due to job stress.
Better social support was linked to lower heart disease risk.

“These findings highlight the importance of screening and treatment of heart disease risks factors to limit not only health care costs, but prevent morbidity and mortality for rheumatoid arthritis patients,” explains Dr Ying Liu, who is involved in the work.

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Image credit: stuartpilbrow