不要RA患者有患心脏疾病的风险增加？
Yes. In a previous post,是否有类风湿关节炎和糖尿病之间的联系？, I referenced一项研究其中比较危险因素在RA患者中糖尿病与心血管疾病。这项研究的结果表明，类风湿关节炎患者有2-3倍的风险动脉粥样硬化（具体冠状动脉疾病）的健康对照组相比。一项类似的研究证实了这些结果;看到"Atherosclerosis in Rheumatoid Arthritis Versus Diabetes: A Comparative Study."
What does cardiovascular disease look like in rheumatoid arthritis?
The chronic inflammation which damages joints also takes its toll on the heart and arteries. The doctors at Johns Hopkins providea summary of recent studies focused on RA and heart disease。Compared to the general population, rheumatoid arthritis patients have a significantly increased risk of heart attack and stroke and a shorter life expectancy.
- Heart attacks are twice as common among women with rheumatoid arthritis as among those without the disease.
- Atherosclerosis ("hardening of the arteries") starts early and progresses more rapidly in people with rheumatoid arthritis.
- 颈动脉阻塞（中风的危险因素）的三倍类风湿关节炎比人在人多不常见的疾病（44％对15％）。
- Cardiovascular events, such as heart attack and stroke, occur about 10 years earlier in people with rheumatoid arthritis.
- Mortality is higher among rheumatoid arthritis patients after a first heart attack.
- 血管损伤是经常在类风湿性关节炎诊断时已经清楚。
- Heart attacks in rheumatoid arthritis patients are more likely to be silent or to occur without the typical symptoms, and they more often result in sudden cardiac death.
- Congestive heart failure (weakening of the heart's pumping ability) is more common among people with rheumatoid arthritis.
累积免疫系统细胞（引起的慢性炎症）吸引胆固醇，血液中的血小板，细胞碎片，和钙的沉积，其聚集在一起以形成噬斑。随着斑块沉积生长，它们限制通过动脉的血流。如果斑块破裂，血栓可以摆脱和旅行到心脏或大脑，在那里他们可能会导致心脏发作或中风。
类风湿关节炎的人可降低心脏疾病的风险，他们的？
The medical community is calling for more awareness of the connection between rheumatoid arthritis and cardiovascular disease. Once you have cardiovascular disease (CVD), it significantly impacts your quality of life and cuts your life expectancy. Although there are few guidelines for preventing heart disease when you have rheumatoid arthritis, following these general pointers to reduce CVD risk can make a difference.
——控制炎症。引起的炎症rheumatoid arthritis that contributes to atherosclerosis, or the buildup of plaque in your arteries. When the arteries become clogged, clots form and you can suffer a heart attack or stroke.
- Cut your fat intake. Avoid using products containing trans, hydrogenated or saturated fat, such as margarine, shortening, butter, and processed or packaged foods. Use healthy oils such as olive oil, especially extra virgin olive oil, almond oil, and sesame oil.
- 吃富含脂肪的鱼。研究表明，在ω-3脂肪酸的鱼高，二十碳五烯酸（EPA）二十二碳六烯酸（DHA），提供若干心脏好处。根据美国心脏协会（AHA），ω-3脂肪酸降低甘油三酯水平和粥样硬化斑块的增长速度，decresed心律失常，从而导致心源性猝死，并略微降低高血压的风险。
美国心脏协会建议吃富含脂肪的鱼类，如金枪鱼，鲱鱼，鳟鱼或鲑鱼至少每周两次。大豆，油菜，核桃和亚麻籽含有α-亚麻酸，其断裂转换成在你的身体的ω-3脂肪酸。您还可以采取EPA和DHA胶囊形式的医疗监督下。
- 经常锻炼。体育锻炼可以减压炎症和类风湿性关节炎的症状 - 并提高心血管健康。每天只需运动30分钟，每周5天，可以降低高血压和胆固醇水平，当你有RA，国家关节炎基金会。
Stick to (or increase) your therapeutic exercises. Also, add aerobic, strength-training, and meditative exercises to your routine. Always get advice from your rheumatologist and physical therapist before starting an exercise plan.
- Maintain a healthy body weight and manage stress levels. Obesity is a key risk factor for heart disease and even a 5-10% weight reduction is beneficial for your joints and your heart.
- 戒烟。吸烟是心脏疾病的主要原因之一。它增加了血压和血液凝块的趋势，并降低好胆固醇和锻炼，各国的AHA。这是在动脉粥样硬化的主要因素或脂肪组织的动脉中堆积之一。研究还表明，炎症标记物，如C反应蛋白和白细胞计数的，吸烟增加的水平。炎症致癌物质有助于动脉粥样硬化为好。
- Cut out salt. High sodium intake increases your blood pressure, which increases the risk of heart disease. The AHA advises most people to eat less than 2,300 mg of salt per day. However, if you are African American, middle-aged or older, or already have high blood pressure, aim for less than 1,500 mg per day. Most prepared foods contain high sodium levels, so be sure to read labels. Also, use spices when you're cooking for flavor, instead of salt.
- Talk to your doctor. Get regular medical checkups and heart disease screening tests for high blood pressure, blood sugars, and high cholesterol. Have an electrocardiogram. Talk to your doctor about your health history and your family history of heart disease.
What are the signs and symptoms of a heart attack?
一些heart attacks are sudden and intense- “电影心脏攻击” - 没有人怀疑发生了什么。但大多数心脏发作启动缓慢，有轻度疼痛或不适。通常受影响的人不知道什么是错的，等待时间过长得到帮助之前。这里有个警告标志，可能意味着心脏攻击正在发生的事情：
- Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- 不适，在上部身体的其他部位。症状可包括在一个疼痛或不适或两个臂，背部，颈部，下巴或胃。
- 气促。这可能发生之前，有或没有胸部不适。
- Other signs. These may include breaking out in a cold sweat, or experiencing nausea or lightheadedness.
了解迹象。即使你不知道这是一个心脏发作，把它签出。分重要。快速行动可以拯救生命，也许你自己。不要等待超过五分钟拨打911。
For More Information:Rheumatoid Arthritis and Heart Disease, Arthritis Foundation.
类风湿性关节炎是多支冠状动脉疾病的独立危险因素的病例对照研究。灵顿KJ，肯特PD等。Arthritis Research & Therapy。2005;7（5）：R984-R991。
动脉粥样硬化和原型炎性疾病类风湿性关节炎和系统性红斑狼疮之间不可分割的联系。Full LE, Ruisanchez C, Monaco C.Arthritis Research & Therapy。2009; 11(2): 217.
心血管疾病在类风湿关节炎患者：从QUEST-RA研究结果。Naranjo A, Sokka T, the QUEST-RA Group, et al.Arthritis Research & Therapy。2008; 10(2): R30.
Tackling ischaemic heart disease in rheumatoid arthritis。Kitas GD, Erb N.Rheumatology。2003; 42: 607-613.