Rheumatoid Arthritis and Heart Disease

Increased Risk of Unrecognized Heart Disease and Cardiac Sudden Death

Man with angina
Rheumatoid Arthritis and heart disease. Science Photo Library / Getty Images

Rheumatoid Arthritis Patients Have Higher Heart Disease Risk

Previous research has revealed that rheumatoid arthritis patients have a higher risk of early death, most likely due to cardiovascular disease. Mayo Clinic researchers have concluded from a study that not only do people with rheumatoid arthritis have a higher risk of coronary heart disease than the general population, they have:

  • more silent, unrecognized heart attacks
  • more sudden cardiac deaths

Interestingly, however, rheumatoid arthritis patients are much less likely to complain of chest pain.

About the Study

Mayo Clinic researchers studied 603 Rochester residents diagnosed with rheumatoid arthritis between January 1, 1955 and January 1, 1995. Researchers compared that group to 603 Rochester residents of the same ages and gender who did not have rheumatoid arthritis. Both groups were followed up for a median of 26 years before rheumatoid arthritis diagnosis and 15 years after diagnosis. Information was gathered about all study participants, focusing on cardiac events and traditional cardiovascular risk factors such as:

Researchers believe the increased heart disease risk may exist even prior to the diagnosis of rheumatoid arthritis. During the two years before diagnosis with rheumatoid arthritis, people with rheumatoid arthritis were:

  • three times more likely to have been hospitalized for an acute heart attack
  • less likely to have a history of chest pains
  • five times more likely to have an unrecognized heart attack

After diagnosis with rheumatoid arthritis, the group was twice as likely to have unrecognized heart attacks and sudden cardiac deaths.

Study Conclusions

Mayo Clinic researchers drew three important conclusions from the findings and suggested rheumatoid arthritis patients need to be aware:

  • The risk of heart attack already exists by the time the diagnosis of rheumatoid arthritis is formulated.
  • Heart disease can be silent in people with rheumatoid arthritis, making regular cardiac checkups necessary, as well as lowering traditional cardiac risk factors (e.g., blood pressure, cholesterol, smoking).
  • In rheumatoid arthritis patients, the first evidence of heart disease can occur as cardiac sudden death.

Researchers believe that in rheumatoid arthritis patients, more than one factor is contributing to the association with heart disease, other than the so-called traditional risk factors for heart disease. It has been theorized that rheumatoid arthritis and heart disease have a common origin, and that the systemic inflammation involved in rheumatoid arthritis might also promote cardiovascular disease and cardiovascular death.

Mayo Clinic researchers emphasize that rheumatoid arthritis patients must recognize that they have a higher risk for heart disease. Rheumatoid arthritis patients must be vigilant about any cardiac symptoms they may experience, and seek prompt medical care if that occurs.

Researchers also suggest that since many rheumatoid arthritis patients take painkillers to control joint pain, they do not recognize or feel chest pain the same way a person would who does not take painkillers.

The goal of future research is to definitively find the reason for the apparent connection between rheumatoid arthritis and heart disease.


Mayo Clinic News Release. Arthritis and Rheumatism. February 2005.

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