Polymyalgia Rheumatica Increases CV Risk

A new study finds individuals with polymyalgia rheumatica (PMR) are at greater risk of heart attack, stroke, and other vascular diseases.

A team including researchers from Keele University in Staffordshire, England examined data of 3,249 patients with polymyalgia rheumatica, a common inflammatory disorder among seniors that causes pain and stiffness. The investigators also studied 12,735 patients who did not have this condition. Both groups were treated by primary care physicians, and none of the patients had a history of vascular disease.
_____________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Myalgia in the Elderly: Arthritis . . . or Something Else?
Neuromuscular Diseases in Geriatric Patients
_____________________________________________________________________________________________________________________________________________________________

In following the participants for 12 years, the investigators found that patients in the polymyalgia rheumatica group had a higher risk for all vascular diseases, including angina, heart attack, atherosclerosis, and stroke. This finding held true among both men and women, with these patients being at greatest risk between 5 and 12 months after being diagnosed with polymyalgia rheumatica, according to the authors. Age was also an influencing factor, with patients between the ages of 50 and 59 at 5 times the risk for vascular disease, while patients age 80 and older were at 3 times the risk.  

Primary care physicians “are increasingly aware of the association between vascular disease and inflammatory rheumatological disorders,” says Christian Mallen, FRCGP, PhD, a professor of general practice research at Keele University, and co-author of the study.

In primary care, screening and active management of vascular risk factors such as high blood pressure and hyperlipaemia are commonplace for conditions including rheumatoid arthritis, says Mallen.

Evidence has been lacking, however, for other inflammatory conditions such as polymyalgia rheumatica, he says.

“As such, vascular risk factors are not routinely attended to in this patient group. Using data from primary care, the setting where most patients with PMR are managed, we have found that patients with PMR are at risk of excess vascular events,” says Mallen. “[Thus], when assessing and monitoring these patients, it is important that primary care physicians also pay particular attention to common vascular risk factors to try and attenuate the risk of future adverse outcomes.” 

—Mark McGraw

Reference

Hancock A, Mallen C, et al. Risk of vascular events in patients with polymyalgia rheumatica. CMAJ. 2014.