%0 Journal Article
%T The role of inflammation and cardiovascular disease risk on microvascular and macrovascular endothelial function in patients with rheumatoid arthritis: a cross-sectional and longitudinal study
%A Aamer Sandoo
%A George D Kitas
%A Douglas Carroll
%A Jet JCS Veldhuijzen van Zanten
%J Arthritis Research & Therapy
%D 2012
%I BioMed Central
%R 10.1186/ar3847
%X Microvascular endothelial function (laser Doppler imaging with iontophoresis of acetylcholine and sodium-nitroprusside), and macrovascular endothelial function (flow-mediated dilatation and glyceryl-trinitrate-mediated dilatation) were analyzed in parallel with disease activity. Individual CVD risk factors and global CVD risk were assessed cross-sectionally in 99 unselected RA patients and longitudinally (baseline, 2 weeks, and 3 months) in 23 RA patients commencing anti-TNF-¦Á therapy.In this cross-sectional study, regression analyses revealed that markers of RA disease-related inflammation were not associated with microvascular or macrovascular endothelium-dependent function (P > 0.05); global CVD risk inversely correlated with microvascular endothelium-dependent function (P < 0.01) and with macrovascular endothelium-independent function (P < 0.01). In the longitudinal study, only microvascular endothelium-dependent function showed an improvement after 2 weeks of anti-TNF-¦Á treatment when compared with baseline (437% ¡À 247% versus 319% ¡À 217%; P = 0.001), but no association was evident between change in endothelial function and change in inflammatory markers.Classical CVD risk may influence endothelial function more than disease-related markers of inflammation in RA. Classical CVD risk factors and anti-TNF-¦Á medication have different effects on microvascular and macrovascular endothelial function, suggesting that combined CVD-prevention approaches may be necessary. Prospective studies examining whether assessments of vascular function are predictive of long-term CV outcomes in RA are required.Rheumatoid arthritis (RA) is a chronic inflammatory musculoskeletal disease that affects ~0.8% of the adult population. RA also associates with an increased risk for cardiovascular disease (CVD) [1], which is only partially explained by traditional CVD risk factors [2]. The inflammatory processes of RA and CVD are remarkably similar, suggesting that RA disease-related inflamma
%U http://arthritis-research.com/content/14/3/R117