[Cardiovascular risk in rheumatic diseases]

Abstract

Cardiovascular diseases, as a result of atherosclerosis, are the leading cause of mortality in the world. Atherosclerosis used to be considered as a degenerative impairment of the artery wall. Nevertheless, it is presently rather regarded as an autoimmune process with the involvement of both innate and adaptive immunity. Recently, it was demonstrated that the cardiovascular risk is increased in autoimmune diseases.In the pathogenesis of atherosclerosis in chronic inflammatory diseases both traditional and non-traditional risk factors are important. Despite the fact that chronic inflammatory diseases are generally considered as nonfatal disorders, they are associated with an increased cardiovascular mortality, probably due to accelerated atherosclerosis. The largest body of evidence of the increased cardiovascular risk was collected in patients with rheumatoid arthritis and systemic lupus erythematosus. There is incomparably less evidence of the cardiovascular risk in other rheumatic diseases.Owing to these findings The European League Against Rheumatism (EULAR) published recommendations for the management of the cardiovascular risk. The update of these recommendations in 2013 and new recommendations published in October 2016 took into account new studies and experiences. Regular screening of the cardiovascular risk and a tight control of rheumatic disease activity remain the cornerstones of the treatment. The cooperation of specialists is important, including the primary care. Nevertheless, many unclear issues are yet to be elucidated.

Keywords: atherosclerosis rheumatic diseases.; cardiovascular risk.