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银屑病关节炎和类风湿关节炎中心血管危险因素的发生率及管理:一项基于人群的研究。

Incidence and Management of Cardiovascular Risk Factors in Psoriatic Arthritis and Rheumatoid Arthritis: A Population-Based Study.

作者信息

Jafri Kashif, Bartels Christie M, Shin Daniel, Gelfand Joel M, Ogdie Alexis

机构信息

University of California, San Francisco.

University of Wisconsin School of Medicine and Public Health, Madison.

出版信息

Arthritis Care Res (Hoboken). 2017 Jan;69(1):51-57. doi: 10.1002/acr.23094. Epub 2016 Nov 28.

Abstract

OBJECTIVE

To examine the prevalence and incidence of cardiovascular (CV) risk factors, including hypertension, hyperlipidemia, diabetes mellitus (DM), and obesity among patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) compared to the general population, and to examine the treatment of incident CV risk factors in PsA and RA compared to controls.

METHODS

A cohort study was conducted within The Health Improvement Network, a medical record database in the UK, using data from 1994 to 2014. Patients ages 18-89 years with PsA or RA were matched to controls on practice and start date. The prevalence and incidence of CV risk factors identified by diagnostic codes were calculated. Cox proportional hazards models were used to examine the relative incidence of these CV risk factors. Finally, pharmacologic therapies for incident CV risk factors were examined.

RESULTS

Study subjects included patients with PsA (n = 12,548), RA (n = 53,215), and controls (n = 389,269). The prevalence of all CV risk factors was significantly elevated in PsA. Only the prevalence of DM and obesity was increased in RA. Incidence of hypertension, hyperlipidemia, and DM was elevated in PsA and RA. Receipt of therapy within 1 year following incident diagnosis of CV risk factors was not substantially different between the groups; approximately 85%, 65%, and 45% of patients received prescriptions for hypertension, hyperlipidemia, and DM, respectively.

CONCLUSION

Patients with PsA have an increased prevalence of CV risk factors, and both patients with PsA and patients with RA have increased incidence of a new diagnosis of CV risk factors. Pharmacologic treatment of CV risk factors in patients with PsA and RA was similar to controls in the UK.

摘要

目的

与普通人群相比,研究银屑病关节炎(PsA)和类风湿关节炎(RA)患者中心血管(CV)危险因素(包括高血压、高脂血症、糖尿病(DM)和肥胖)的患病率和发病率,并比较PsA和RA中CV危险因素的新发治疗情况与对照组。

方法

在英国的一个病历数据库——健康改善网络中进行了一项队列研究,使用1994年至2014年的数据。将年龄在18 - 89岁的PsA或RA患者与对照组按医疗机构和开始日期进行匹配。计算通过诊断编码确定的CV危险因素的患病率和发病率。使用Cox比例风险模型来研究这些CV危险因素的相对发病率。最后,研究了CV危险因素新发的药物治疗情况。

结果

研究对象包括PsA患者(n = 12,548)、RA患者(n = 53,215)和对照组(n = 389,269)。PsA患者中所有CV危险因素的患病率均显著升高。RA患者中仅DM和肥胖的患病率增加。PsA和RA患者中高血压、高脂血症和DM的发病率升高。在CV危险因素新发诊断后的1年内接受治疗的情况在各组之间没有显著差异;分别约有85%、65%和45%的患者接受了高血压、高脂血症和DM的处方治疗。

结论

PsA患者CV危险因素的患病率增加,PsA患者和RA患者中CV危险因素新发诊断的发病率均增加。在英国,PsA和RA患者中CV危险因素的药物治疗情况与对照组相似。

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