Cardiovascular complications in patients with rheumatic diseases.

Abstract

In the recent years, there are more and more reports stating an increased risk of atherosclerosis and cardiovascular complications in patients with rheumatic diseases. It should be noted that the development of atherosclerosis in this category of patients occurs much earlier than in the general population. Indeed, many rheumatic diseases are associated with an increased risk of developing of cardiovascular diseases and death from vascular accidents, including RA, systemic lupus erythematosus, ankylosing spondylitis, gout, psoriatic arthritis, vasculitis of the middle and large vessels. There are reports of an increased risk of cardiovascular disease in patients with systemic scleroderma. It is significant that rheumatic diseases and coronary heart disease combine common pathophysiological mechanisms - systemic and chronic inflammation. At the same time, traditional risk factors such as hypertension, old age, smoking, hypercholesterolemia, obesity and male sex can not fully explain the mechanism of accelerated development of atherosclerosis in patients with rheumatic diseases. The presence of specific risk factors, such as the duration of the course of treatment, glucocorticosteroids administration, the presence of an increased concentration of inflammatory mediators and autoimmune mechanisms create conditions for the acceleration of atherosclerosis in this group of patients. Coordination of efforts of rheumatologists and cardiologists in studying the mechanisms of accelerated development of atherosclerosis in patients with rheumatic diseases will allow to develop adequate methods for timely diagnosis and prevention of cardiovascular complications in patients with this widespread pathology.