THU0682 UNDERDIAGNOSIS OF TRADITIONAL CARDIOVASCULAR RISK FACTORS IN RHEUMATIC DISEASES
Authors: Ileana Cecilia Reynosa-Silva, Dionicio Ángel Galarza-Delgado, Iris Jazmin Colunga-Pedraza, José Ramón Azpiri-López, Iván de Jesús Hernández-Galarza, Karla Paola Cuéllar-Calderón, Marielva Castro-González, Carolina Marlene Martínez-Flores
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Patients with rheumatic diseases (RD) have a higher cardiovascular risk (CVR), compared to the general population (1). The increased risk, in this population, tends to be associated with the chronic inflammation generated by RD. Another contributor is the coexistence of traditional CVR factors, such as diabetes, hypertension, obesity, smoking, and dyslipidemia (2). It is known that adequate control of this factors can reduce the overall CVR. Due to the increased CVR burden, there's a growing awareness of cardiovascular assessment in rheumatic patients. Therefore, the 2016 EULAR guidelines recommend making this assessment every 5 years, in order to decrease their morbidity and mortality by early treatment. <h3>Objectives</h3> To determine the prevalence of underdiagnosis and inefficient treatment of traditional cardiovascular risk factors in RD patients. <h3>Methods</h3> A cross-sectional, observational study of patients between 30 and 75 years with rheumatoid arthritis (RA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) recruited at the rheumatology clinic at a University Hospital in northeastern Mexico. Exclusion criteria: previous cardiovascular disease, overlap syndromes, diabetes, or pregnancy. Evaluation included history of lifestyle, comorbidities, medications, blood pressure, anthropometry and fasting glucose measures. Framingham-BMI (FRS-BMI) was used to calculate their predicted CVR to 10 years. <h3>Results</h3> A total of 382 patients were recruited, 90.6% were women (n=346), with a median age of 53 years (45-59). In this population, 87.4% of the patients (n=334) had at least one CVR factor; the presence of traditional CVR factors according to RD is shown in Figure 1. Other population characteristics are in Table 1. Around half of the patients were not in their ideal weight, 32% being diagnosed as overweight and 31.4% with obesity. Out of the patients with no previous diagnosis of hypertension (n=350, 91.5%), 36.1% had elevated or high blood pressure levels. The patients that did have previous diagnosis, 68.7% didn't have an adequate control of their blood pressure, even though they're on pharmacological treatment. History of dyslipidemia was found in 5.2% of patients. Half of them arrived at consultation with a recent lipid profile, having a median LDL of 133.5 (109-158) mg/dL, not meeting target levels. Even though no diabetic patients were included, 20.8% of the patients had hyperglycemia. According to FRS-BMI, 80.4% of the patients had a low CVR, 14.9% moderate risk, and 4.7% had a high CVR. <h3>Conclusion</h3> In this study, an underdiagnosis and insufficient treatment of traditional CVR factors in rheumatic patients was found. Besides having a RD and at least one traditional CVR factor, 19.6% of the patients had a moderate or high CVR according to FRS-BMI. The observed burden of CVR factors in RD is significant. Therefore, rheumatologists must improve the CV assessment made to each of their patients. <h3>References</h3> [1] Eder, L et al (2018). Gaps in Diagnosis and Treatment of Cardiovascular Risk Factors in Patients with Psoriatic Disease: An International Multicenter Study. The Journal of Rheumatology, 45(3), 378–384. http://doi.org/10.3899/jrheum.170379 [2] Nurmohamed MT, et al (2015). Cardiovascular comorbidity in rheumatic diseases. Nature Reviews Rheumatology, 11(12), 693–704. http://doi.org/10.1038/nrrheum.2015.112 <h3>Disclosure of Interests</h3> None declared