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Rand Paul By Rand Paul, 10th Jun 2015 | Follow this author | RSS Feed | Short URL
Posted in Wikinut>Health>General Health>Pain Management

People coping with rheumatoid arthritis have to deal with the risk of heart attack or cardiac arrest. Read more about the connection

Does Rheumatoid Arthritis have a Connection with Cardiac Arrest?

Rheumatic arthritis is known to have a strong association with Cardiac Arrest. According to North American study of mortality among people with Rheumatoid Arthritis; incidence of death due to cardiovascular causes is twice as high in people with Rheumatoid arthritis as in healthy subjects of the same age group. It is clinically found that cardiovascular causes like ischemic heart disease, stroke and cardiac arrest accounts for 40% mortality in people with Rheumatoid Arthritis. The Rochester Epidemiology Project study conducted on people with Rheumatoid Arthritis has shown exist of subclinical, silent Myocardial Infarction in people with Rheumatoid Arthritis which accounts to Cardiac arrest at later stage.

Rheumatoid arthritis is a systemic disease characterized by autoimmune disorder causing inflammation of various tissues of the body. It primarily affects bones and joints but in advance stages it causes inflammation of tissues of lung and heart. The cardiac manifestations of Rheumatoid Arthritis includes inflammation of the coronary arteries, heart valves, conductive tissues of heart (SA node and AV node), and membranes of heart (endocardium and pericardium). There is a remarkable increase in number of antibodies against cardiac conductive tissue in rheumatoid arthritis which results in its inflammation .The inflammation of cardiac conductive tissues accounts for atherosclerosis, cardiac rhythm disorders and cardiac arrest in people with rheumatoid arthritis. According to a comparative study between nodular and non-nodular rheumatoid arthritis, Cardiac arrest occur more often in nodular rheumatoid arthritis than in non-nodular arthritis .

Causes of Cardiac Arrest in Rheumatoid Arthritis

The rhythm and conduction disturbances like acute coronary syndrome and ventricular arrhythmia are the possible reasons of cardiac arrest in people with rheumatoid arthritis. It has been clinically seen that the rheumatoid granulomas and mononuclear cells infiltrate into the AV node, SA node and other conductive tissues of heart causing ventricular arrhythmia. The assessment of rhythm and conductive functions of heart in people with Rheumatoid Arthritis have revealed that there is a significant decrease in Heart Rhythm Variability (HRV) in people with Rheumatoid arthritis which results ventricular arrhythmia and cardiac arrest. In a study conducted on subjects with rheumatoid arthritis it was found that infiltration of AV node by rheumatoid granulomas is responsible for right bundle branch block in about 35% of total 60 subjects with rheumatoid arthritis .

The Autonomic Nervous System (ANS) dysfunction in auto immune disease like rheumatoid arthritis is also associated with incidence of cardiac arrest in people with these conditions. A case-control study was conducted on 90 subjects to study the cardiac autoimmune profile in rheumatic arthritis and systemic lupus erythematous; various parameters like 24 hours blood pressure, 24 hours ECG and cardiovascular reflex were monitored and the results concluded that there is a significant increase in risk of cardiac arrest in people with higher degree of ANS dysfunction . There was a short-term heart rate variability seen in people with ANS dysfunction. The cardiovascular reflexes (as tested by Valsalva manoeuvre, deep breathing exercises and heart rate response to standing) of people with ANS dysfunction were found to be more than that of healthy subjects.

The risk factors like hypertension and smoking are also accountable for cardiac arrest in people with Rheumatoid Arthritis. Reaction of drugs like NSAIDs, Predinisone and other steroidal drugs which are administered in Rheumatoid Arthritis are also known to increase the risk of cardiac arrest in people with rheumatoid arthritis.

Measures to prevent Cardiac arrest in Rheumatoid Arthritis

• since arrhythmias are primarily responsible for cardiac arrest in people with rheumatoid arthritis the administration of Anti-arrhythmic drugs is helpful in people with rheumatoid arthritis. A drug named digoxin is used to suppress ventricular response in Artial fibrillation. The calcium channel blocker like verapamil is used for supra-ventricular arrhythmias.
• Pacemaker implants and preventive implantable cardioverter defibrillators (ICDs) are also beneficial in combating arrhythmias associated with rheumatoid arthritis.
• Dietary management :consumption of low cholesterol and low sodium food products, increase intake of food products rich in dietary fiber, including fresh fruits and vegetables in diet and consuming quality protein.
• Life style management: A proactive life style which includes mild to moderate level of physical activities, quitting smoking and maintaining a healthy weight is helpful in decreasing risk of cardiac arrest in rheumatoid arthritis.

Though there is a strong association with rheumatoid arthritis and cardiac arrest, yet occurrence of cardiac arrest in people with rheumatoid arthritis could be significantly decreased by taking proper and prompt measures. Careful monitoring of blood pressure, blood sugar levels and blood cholesterol level also helps in managing adverse cardiovascular incidence in rheumatoid arthritis.


1. Ymmons DP, Gabriel SE. Epidemiology of CVD in Rheumatic diseases with focus on RA and SLE. Nat Rev Rheumatal.2011;7(7): 399-408
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3. Villecco AS, de Liberali E, Blanchi FB, Pisi E. antibodies to cardiac conducting tissue and abnormalities of cardiac conduction in Rheumatoid Arthritis. Clin Exp/immune/1983;53:536-40
4. Stojanovich L , Milovanovich B, deLuka SR, Popovich, Kuzmanovich D, Bisenich V, Djukanovich B, Randjelovich T, Krotinm. Cardiovascular autonomic dysfunction in SLE, RA, primary SjogrenSyndrome and other auto immune disease. Lupus.2007;16(3):181-5
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author avatar Rand Paul
Rand Paul an Independent health researcher & American author had done MA in English literature. He loves to explore and write about Lifestyle & Health all around the globe. Currently, lives in Washing

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author avatar Sivaramakrishnan A
11th Jun 2015 (#)

Good post with tips to prevent things going out of control, thanks. Many with this disease take it as non curable - siva

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author avatar Rayeen N
11th Jun 2015 (#)

Agreed with the author
cardiac arrest in people with rheumatoid arthritis could be significantly decreased by taking proper and prompt measures.

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author avatar Yvette van Niekerk
11th Jun 2015 (#)

Well written article, very insightful and I have learned some interesting facts. Thank you for the share.

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author avatar Rand Paul
11th Jun 2015 (#)

Thanks a lot for the appreciation.

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