Physicians have increasingly recognized the connection between rheumatoid arthritis (RA) and cardiovascular disease. RA is characterized by systemic immune system activation and high-grade inflammation. In a new international study, published in the Rheumatic and Musculoskeletal Diseases journal, Dr. George Karpouzas, MD, investigator at The Lundquist Institute for Biomedical Innovation, and his colleagues focus on two immune system proteins—rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), both commonly used by physicians to diagnose RA. The researchers discovered that these antibodies may do more than help diagnose the disease. They also appear to influence how inflammation affects the cardiovascular system.
Over time, chronic inflammation can damage blood vessels, accelerate plaque buildup in the arteries, and increase the likelihood of heart disease. Until now, scientists generally assumed this process affected all patients in much the same way.
By following nearly 4,000 people with RA over many years, researchers found that the relationship between inflammation and cardiovascular disease varied depending on each patient’s antibody profile. In other words, not every person with RA experiences the same level of heart disease risk, even if their arthritis appears equally active.
Rather than viewing RA as a single condition with uniform risks, the findings point to a disease that is far more biologically complex. A patient’s unique immune system may influence not only how the disease behaves, but also how it affects organs throughout their body.
Although more research is needed, these findings open the door to a future where physicians can better identify patients who may benefit from earlier cardiovascular screening, more intensive management of inflammation, or additional strategies to reduce their risk of heart disease.
The study also serves as an important reminder that RA is much more than a joint disease. Because the immune system affects the entire body, chronic inflammation can impact the heart, lungs, blood vessels, and other organs. Understanding these connections allows physicians to treat the whole patient—not just the arthritis itself.
Dr. Karpouzas’ research continues to help uncover the biological factors that influence cardiovascular disease in RA. He and his colleagues are advancing knowledge that underscores the advantages of precision medicine—an approach that seeks to tailor prevention and treatment to each individual instead of relying on a one-size-fits-all strategy.
To read the publication, “Rheumatoid factor and anticitrullinated protein antibody status jointly influence the association between disease activity and cardiovascular risk in rheumatoid arthritis,” in the Rheumatic and Musculoskeletal Diseasesjournal, visit: https://rmdopen.bmj.com/content/12/2/e006929