Improving cardiac treatment for patients with autoimmune diseases is the goal of the expanding discipline of cardiorheumatology.
Your body is protected from bacteria, viruses, and other invaders by the network of specialized cells and organs that make up your immune system. However, immune cells sometimes attack the body’s own tissues inappropriately for reasons that are still unknown. As a result, white blood cells and other chemicals are released, causing inflammation and the pain, swelling, and redness that define many autoimmune diseases. However, inflammation also degrades the lining of blood vessels, promoting the buildup of fatty plaque that can cause atherosclerosis, restrict arteries, increase blood pressure, and increase the risk of heart attack or stroke. This relationship likely explains why rates of heart disease are higher in people with autoimmune diseases such as rheumatoid arthritis. But until recently the severity and extent of this problem was unknown.
Autoimmune diseases: from prevalent to rare
Up to 8% of Americans experience an autoimmune disease, which results from the immune system’s involuntary attack on healthy tissues or organs. Women are twice as likely as men to acquire these disorders, for unknown reasons. The three autoimmune diseases listed here are among the most prevalent and best researched of the more than 100 autoimmune diseases identified. However, most of them are rare, making them less known.
Psoriasis It causes inflammation of the skin that produces a scaly, pink or dull red rash that appears in spots, mainly on the scalp, in skin folds, and on the back of the elbow. Psoriatic arthritis, which causes morning stiffness and inflammation of the joints, especially in the fingers, toes or knees, affects about one in three people with psoriasis.
Rheumatoid arthritis. The immune system attacks the tissue that lines the joints, causing inflammation characterized by pain, swelling and stiffness. It usually affects several joints at once, especially the hands and feet. Exhaustion and persistent stiffness in the morning are other symptoms.
Lupus. The inflammatory process that causes lupus can affect almost every organ in the body and cause a wide range of symptoms. Fever and joint discomfort similar to rheumatoid arthritis are typical first symptoms. A notable sign is a “butterfly-shaped rash” that runs along the cheekbones and bridge of the nose. Additionally, damage to the kidneys, lungs, heart and blood vessels can occur.
A higher risk
However, in 2022, research was published in The Lancet that examined the incidence of cardiovascular diseases along with 19 of the most prevalent autoimmune diseases. People with these autoimmune disorders were up to three times more likely than those without them to develop cardiovascular disease, depending on the exact condition.
Many patients under his care have lupus, psoriatic arthritis or rheumatoid arthritis, three common diseases associated with cardiovascular problems.
Since autoimmune diseases typically affect people in their 20s and 30s, it’s especially important to be aware of this increased risk. As a result, heart problems can appear up to ten years earlier than in people without an inflammatory disease. A calcium scan helps determine an individual’s risk and provides treatment recommendations by identifying early indicators of atherosclerosis. Sometimes symptoms (such as breathlessness when climbing stairs) that are actually caused by heart disease are misdiagnosed as rheumatoid arthritis.
Advice on treatment.
Cardiorheumatologists collaborate with rheumatologists to monitor the appropriate use of disease-modifying biologic therapies, some of which have a higher risk of cardiovascular adverse effects than others. They also prescribe statins and other treatments that reduce the risk of heart attacks.
People with autoimmune diseases benefit from the same diets that are recommended to reduce heart disease. Maintaining a healthy weight is also beneficial. Many patients like to swim, which is gentle on the joints. “People with autoimmune diseases, especially those with severe cases of rheumatoid arthritis, may have limited mobility, making exercise particularly challenging.”
Others find yoga beneficial, especially for the additional stress reduction and relaxation it offers. Another activity that could increase your heart rate without straining your joints is using an elliptical machine.
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