Systematic inflammation could contribute to rapid progression of atherosclerosis in people with rheumatoid arthritis, notes research at American College of Rheumatology in Atlanta.

"These data suggest that by limiting inflammation in RA patients, you can potentially limit the rapidity of accumulation of—at least—carotid atherosclerosis, which is what our study looked at," says Jon T. Giles, MD, MPH; assistant professor of medicine in the Division of Rheumatology at Johns Hopkins and lead investigator in the study. "And because carotid atherosclerosis tends to be correlated with coronary atherosclerosis, then potentially you would have fewer cardiovascular events like myocardial infarction and stroke in RA patients. These links with subclinical atherosclerosis make intuitive sense, but they haven't [previously] been shown in prospective studies."

About 1.3 million Americans have been estimated as suffering from RA, an illness that is often linked with pain and stiffness in multiple joints, and is mostly accompanied by inflammation.

Researchers noted that coronary and extra-coronary atherosclerosis—the builds-up of plaque in the artery walls—are increased in people with the disease. Studying 158 people with RA, researchers monitored the intima-medial thickness - the thickness of artery walls that is used in diagnosing atherosclerosis. They took an ultrasound of their common and internal carotid arteries between the 3.2 years of study. They found that the thickness of the common carotid artery walls increased over time in 82 per cent of them.

Observing the thickness of the artery walls, prednisone exposure was the only RA feature researchers associated with progression of atherosclerosis after adjusting the data to consider demographics.

Researchers noted that those with more number of inflamed joints were significantly associated with incidence of plaque.

"There seem to be some medications used in RA that can either be protective or can promote atherosclerosis," Dr. Giles says. "Prednisone may be more associated with progression of atherosclerosis in some vascular beds, but medications like TNF inhibitors and statins that are taken to lower cholesterol may limit atherosclerosis in these patients."

The next stage of research is to study the direct cause-effect relationship."Those studies are in the planning stages," Dr. Giles says.