Inclusion Criteria:  Inclusion criteria:  Patients with RA classified according to the revised American College of Rheumatology (ACR)/EULAR RA classification criteria 2010 for RA. Age ≥ 18 years. Patients who are able and willing to give written informed consent.  Disease duration more than one year  Exclusion Criteria:  Any other autoimmune disease rather than RA. Patients with any disease affecting the cardiovascular system other than RA. Patients with known risk factors for atherosclerosis as diabetes, hypertension, hyperlipidemia and obesity.