Diabetes mellitus and cardiovascular risk management in patients with rheumatoid arthritis: An international audit

Anne Grete Semb, Silvia Rollefstad, Eirik Ikdahl, Grunde Wibetoe, Joseph Sexton, Cindy Crowson, Piet Van Riel, George Kitas, Ian Graham, Solbritt Rantapää-Dahlqvist, George Athanasios Karpouzas, Elena Myasoedova, Miguel A. Gonzalez-Gay, Petros P. Sfikakis, Maria G.G. Tektonidou, Argyro Lazarini, Dimitrios Vassilopoulos, Bindee Kuriya, Carol Hitchon, Maria Simona StoenoiuPatrick Durez, Virginia Pascual-Ramos, Dionicio Angel Galarza-Delgado, Pompilio Faggiano, Durga Prasanna Misra, Andrew A. Borg, Rong Mu, Erkin M. Mirrakhimov, Diane Gheta, Karen Douglas, Vikas Agarwal, Svetlana Myasoedova, Lev Krougly, Tatiana Valentinovna Popkova, Alena TuchyÅ ová, Michal Tomcik, Michal Vrablik, Jiri Lastuvka, Pavel Horak, Helena Kaspar Medkova, Anne M. Kerola

Research output: Contribution to journalArticlepeer-review


Aim The objective was to examine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and its risk factors among patients with RA with diabetes mellitus (RA-DM) and patients with RA without diabetes mellitus (RAwoDM), and to evaluate lipid and blood pressure (BP) goal attainment in RA-DM and RAwoDM in primary and secondary prevention. Methods The cohort was derived from the Survey of Cardiovascular Disease Risk Factors in Patients with Rheumatoid Arthritis from 53 centres/19 countries/3 continents during 2014-2019. We evaluated the prevalence of cardiovascular disease (CVD) among RA-DM and RAwoDM. The study population was divided into those with and without ASCVD, and within these groups we compared risk factors and CVD preventive treatment between RA-DM and RAwoDM. Results The study population comprised of 10 543 patients with RA, of whom 1381 (13%) had DM. ASCVD was present in 26.7% in RA-DM compared with 11.6% RAwoDM (p<0.001). The proportion of patients with a diagnosis of hypertension, hyperlipidaemia and use of lipid-lowering or antihypertensive agents was higher among RA-DM than RAwoDM (p<0.001 for all). The majority of patients with ASCVD did not reach the lipid goal of low-density lipoprotein cholesterol <1.8 mmol/L. The lipid goal attainment was statistically and clinically significantly higher in RA-DM compared with RAwoDM both for patients with and without ASCVD. The systolic BP target of <140 mm Hg was reached by the majority of patients, and there were no statistically nor clinically significant differences in attainment of BP targets between RA-DM and RAwoDM. Conclusion CVD preventive medication use and prevalence of ASCVD were higher in RA-DM than in RAwoDM, and lipid goals were also more frequently obtained in RA-DM. Lessons may be learnt from CVD prevention programmes in DM to clinically benefit patients with RA.

Original languageEnglish (US)
Article numbere001724
JournalRMD Open
Issue number2
StatePublished - Jul 8 2021


  • arthritis
  • atherosclerosis
  • cardiovascular diseases
  • hypertension
  • lipids
  • rheumatoid

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology


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