Explaining how "high-grade" systemic inflammation accelerates vascular risk in rheumatoid arthritis

Sattar, N. , McCarey, D.W., Capell, H. and McInnes, I.B. (2003) Explaining how "high-grade" systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation, 108(24), pp. 2957-2963. (doi:10.1161/01.CIR.0000099844.31524.05) (PMID:14676136)

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Abstract

There is intense interest in mechanisms whereby low-grade inflammation could interact with conventional and novel vascular risk factors to promote the atheromatous lesion. Patients with rheumatoid arthritis (RA), who by definition manifest persistent high levels of inflammation, are at greater risk of developing cardiovascular disease. Mechanisms mediating this enhanced risk are ill defined. On the basis of available evidence, we argue here that the systemic inflammatory response in RA is critical to accelerated atherogenesis operating via accentuation of established and novel risk factor pathways. By implication, long-term suppression of the systemic inflammatory response in RA should be effective in reducing risk of coronary heart disease. Early epidemiological observational and clinical studies are commensurate with this hypothesis. By contrast, risk factor modulation with conventional agents, such as statins, may provide unpredictable clinical benefit in the context of uncontrolled systemic inflammatory parameters. Unraveling such complex relationships in which exaggerated inflammation-risk factor interactions are prevalent may elicit novel insights to effector mechanisms in vascular disease generally.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McInnes, Professor Iain and Capell, Dr Hilary and McCarey, Dr David and Sattar, Professor Naveed
Authors: Sattar, N., McCarey, D.W., Capell, H., and McInnes, I.B.
Subjects:R Medicine > RB Pathology
Q Science > QP Physiology
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Circulation
ISSN:1524-4539

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