Exploring Cardiovascular Risk Factors and Atherosclerosis in Rheumatoid Arthritis.

• RA patients face an increased risk of CV diseases due to systemic inflammation and disease activity. • Other than traditional CV risk factors in RA patients, systemic inflammation and autoantibodies contribute to the heightened CV risk. • RA patients have low TC, LDL, and HDL but still experience high rates of CV events, known as the "lipid paradox," due to increased cholesterol breakdown and altered HDL function from inflammation. • In RA patients, inflammatory markers like CRP and cytokines promote atherosclerosis. • Early and aggressive intervention with DMARDs is crucial in achieving clinical remission, and potentially lowering the risk of CV events in RA patients. Rheumatoid arthritis (RA) is a chronic inflammatory disease mainly affecting the peripheral diarthrodial joints symmetrically and also presenting many extra-articular manifestations. Morbidity and mortality in RA patients are higher compared to the general population. Cardiovascular (CV) disease is one of the most common causes of death in these patients. Classical or traditional risk factors for atherosclerosis development occur more frequently in RA patients compared to those without this condition. Studies have showed that RA patients often present comorbidities such as hypertension, dyslipidemia, diabetes mellitus and obesity. However, the high incidence of CV events occurring in RA patients is not explained by the presence of traditional risk factors. Systemic inflammation, as it is expressed with the presence of proinflammatory cytokines and increased acute phase reactants, may contribute to the development of premature atherosclerosis in these patients. In this review, we explore the risk factors for CV disease, the generation of dyslipidemia, the lipid paradox and the role of systemic inflammation in the atherosclerotic process in RA. We discuss also the role of early therapeutic intervention that suppresses inflammation which may have beneficial effects on CV disease in RA patients. [ABSTRACT FROM AUTHOR]