Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country

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dc.contributor.authorSolomon, Ahmeden_ZA
dc.contributor.authorStanwix, Anne E.en_ZA
dc.contributor.authorCastaneda, Santosen_ZA
dc.contributor.authorLlorca, Javieren_ZA
dc.contributor.authorGonzalez-Juanatey, Carlosen_ZA
dc.contributor.authorHodkinson, Bridgeten_ZA
dc.contributor.authorRomela, Benithaen_ZA
dc.contributor.authorAlly, Mahmood M. T. M.en_ZA
dc.contributor.authorMaharaj, Ajesh B.en_ZA
dc.contributor.authorVan Duuren, Elsa M.en_ZA
dc.contributor.authorZiki, Joyce J.en_ZA
dc.contributor.authorSeboka, Mpotien_ZA
dc.contributor.authorMohapi, Makgotsoen_ZA
dc.contributor.authorJansen Van Rensburg, Barend J.en_ZA
dc.contributor.authorTarr, Gareth S.en_ZA
dc.contributor.authorMakan, Kavitaen_ZA
dc.contributor.authorBalton, Charleneen_ZA
dc.contributor.authorGogakis, Aphroditeen_ZA
dc.contributor.authorGonzález-Gay, Miguel A.en_ZA
dc.contributor.authorDessein, Patrick H.en_ZA
dc.date.accessioned2020-06-25T12:32:13Z
dc.date.available2020-06-25T12:32:13Z
dc.date.issued2020-06-16
dc.date.updated2020-06-21T03:44:01Z
dc.descriptionCITATION: Solomon, A., et al. 2020. Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country. BMC Rheumatology, 4:42, doi:10.1186/s41927-020-00139-2.
dc.descriptionThe original publication is available at https://pubmed.ncbi.nlm.nih.gov/32550295/
dc.description.abstractBackground: It is plausible that optimal cardiovascular disease (CVD) risk management differs in patients with rheumatoid arthritis (RA) from low or middle income compared to high income populations. This study aimed at producing evidence-based points to consider for CVD prevention in South African RA patients. Methods: Five rheumatologists, one cardiologist and one epidemiologist with experience in CVD risk management in RA patients, as well as two patient representatives, two health professionals and one radiologist, one rheumatology fellow and 11 rheumatologists that treat RA patients regularly contributed. Systematic literature searches were performed and the level of evidence was determined according to standard guidelines. Results: Eighteen points to consider were formulated. These were grouped into 6 categories that comprised overall CVD risk assessment and management (n = 4), and specific interventions aimed at reducing CVD risk including RA control with disease modifying anti-rheumatic drugs, glucocorticoids and non-steroidal anti-inflammatory drugs (n = 3), lipid lowering agents (n = 8), antihypertensive drugs (n = 1), low dose aspirin (n = 1) and lifestyle modification (n = 1). Each point to consider differs partially or completely from recommendations previously reported for CVD risk management in RA patients from high income populations. Currently recommended CVD risk calculators do not reliably identify South African black RA patients with very high-risk atherosclerosis as represented by carotid artery plaque presence on ultrasound. Conclusions: Our findings indicate that optimal cardiovascular risk management likely differs substantially in RA patients from low or middle income compared to high income populations. There is an urgent need for future multicentre longitudinal studies on CVD risk in black African patients with RA.
dc.description.urihttps://bmcrheumatol.biomedcentral.com/articles/10.1186/s41927-020-00139-2
dc.description.versionPublisher's version
dc.format.extent16 pagesen_ZA
dc.identifier.citationSolomon, A., et al. 2020. Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country. BMC Rheumatology, 4:42, doi:10.1186/s41927-020-00139-2
dc.identifier.issn2520-1026 (online)
dc.identifier.otherdoi:10.1186/s41927-020-00139-2
dc.identifier.urihttp://hdl.handle.net/10019.1/108677
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.rights.holderAuthors retain copyright
dc.subjectRheumatoid arthritis -- Medical care
dc.subjectCardiovascular system -- Diseases -- Risk Managementen_ZA
dc.subjectInequality of incomeen_ZA
dc.titlePoints to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income countryen_ZA
dc.typeArticle
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