Cardiovascular risk factors in patients with rheumatoid arthritis at Kenyatta National Hospital
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Date
2009Author
Kipkorir, Fredrick K
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Introduction and background
Rheumatoid arthritis is associated with excess cardiovascular morbidity and mortality
predominantly due to accelerated coronary artery and cerebrovascular atherosclerosis.
Objective:
To identify traditional cardiovascular risk factors in patients with rheumatoid arthritis at
Kenyatta National Hospital and compare with healthy controls
Study design/site:
This was a descriptive comparative cross sectional survey done at KNH medical
outpatient clinic. The study population consisted of patients with rheumatoid arthritis and
the controls were individuals without RA age and sex matched staff of KNH. All those
who consented were enrolled and a clinical evaluation was done. Consecutive sampling
was done on those who fulfilled ACR criteria for patients with RA and also for the
controls who consented to participate in the trial.
Methodology
The patients/controls who met inclusion criteria and signed an informed consent, filled a
questionnaire with the help of an assistant and had their weight, height, Blood pressure,
waist circumference, hip circumference measured. Blood was also taken for fasting blood
sugar and lipid profile analysis. They were given back their results and accorded
treatment according to the outcome of their results.
Results
One hundred patients with RA were screened out of which 80 were enrolled. In the
control group one hundred and five were screened, twenty five were excluded and 80
were enrolled. The prevalence of hypertension among RA patients was 41.3 %( 24.4-
58.1) Vs 22.5% (3.2-41.8) in the control group and this was statistically significant (P =
0.017). Diabetes in RA patients was 6.3% Vs 5% (p =1) in the controls, prevalence of
dyslipidemia in RA patients was 71.3 % (59.6-83) Vs 73.8 % (62.6-85) in the control
group (p =0.723). The prevalence of smoking in RA patients was 5% Vs 2.5% (p=0.681)
in the control group, while the prevalence of obesity was 22.5% in the patients with RA
Vs 32.5% in the control group (p=0.157). Study participants with abnormal WHR were
33.8% in those with RA Vs 33.8% in the control group. Family history of sudden death in
patients with RA was 5% Vs 10% in the controls, no family history of stroke or heart
attack was reported in the patients with RA. Ten percent of the controls had a family
history of sudden death. Family history stroke was 1.3% in the controls and no history of
heart attack was reported in the control group. Eighty percent of patients with RA were
on at least one DMARD, 57.5% were on steroids and 37.5% were on NSAIDS.
Conclusion
There is a high prevalence of hypertension in patients with RA; hypertension was also
associated with the use of DMARDS and steroids and this was statistically significant.
There was no significant difference between patients and controls in terms of other risk
factors such as diabetes mellitus, dyslipidemia, smoking, BMI, WHR, and family history
of cardiovascular events.
Recommendations
Clinicians should keenly look out for hypertension In patients with RA for early
identification and manage it appropriately.
Citation
Master of Medicine in Internal Medicine, The University Of Nairobi, 2009Publisher
University of Nairobi. Faculty of Medicine