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, Ahmed
dc.contributor.authorStanwix, Anne E
dc.contributor.authorCastañeda, Santos
dc.contributor.authorLlorca, Javier
dc.contributor.authorGonzalez-Juanatey, Carlos
dc.contributor.authorHodkinson, Bridget
dc.contributor.authorRomela, Benitha
dc.contributor.authorAlly, Mahmood M T M
dc.contributor.authorMaharaj, Ajesh B
dc.contributor.authorVan Duuren, Elsa M
dc.contributor.authorZiki, Joyce J
dc.contributor.authorSeboka, Mpoti
dc.contributor.authorMohapi, Makgotso
dc.contributor.authorJansen Van Rensburg, Barend J
dc.contributor.authorTarr, Gareth S
dc.contributor.authorMakan, Kavita
dc.contributor.authorBalton, Charlene
dc.contributor.authorGogakis, Aphrodite
dc.contributor.authorGonzález-Gay, Miguel A
dc.contributor.authorDessein, Patrick H
dc.date.accessioned2020-06-25T08:45:43Z
dc.date.available2020-06-25T08:45:43Z
dc.date.issued2020-06-16
dc.date.updated2020-06-21T03:41:11Z
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.en_US
dc.identifier.apacitationSolomon, A., Stanwix, A. E., Castañeda, S., Llorca, J., Gonzalez-Juanatey, C., Hodkinson, B., ... Dessein, P. H. (2020). Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country. <i>BMC Rheumatology</i>, 4(1), 42. en_ZA
dc.identifier.chicagocitationSolomon, Ahmed, Anne E Stanwix, Santos Castañeda, Javier Llorca, Carlos Gonzalez-Juanatey, Bridget Hodkinson, Benitha Romela, et al "Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country." <i>BMC Rheumatology</i> 4, 1. (2020): 42. en_ZA
dc.identifier.citationSolomon, A., Stanwix, A.E., Castañeda, S., Llorca, J., Gonzalez-Juanatey, C., Hodkinson, B., Romela, B. & Ally, M.M.T.M. 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. <i>BMC Rheumatology.</i> 4(1):42. en_ZA
dc.identifier.ris TY - Journal Article AU - Solomon, Ahmed AU - Stanwix, Anne E AU - Castañeda, Santos AU - Llorca, Javier AU - Gonzalez-Juanatey, Carlos AU - Hodkinson, Bridget AU - Romela, Benitha AU - Ally, Mahmood M T M AU - Maharaj, Ajesh B AU - Van Duuren, Elsa M AU - Ziki, Joyce J AU - Seboka, Mpoti AU - Mohapi, Makgotso AU - Jansen Van Rensburg, Barend J AU - Tarr, Gareth S AU - Makan, Kavita AU - Balton, Charlene AU - Gogakis, Aphrodite AU - González-Gay, Miguel A AU - Dessein, Patrick H AB - Background 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. DA - 2020-06-16 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Rheumatology KW - Cardiovascular disease risk management KW - Rheumatoid arthritis KW - Low to middle income countries KW - South Africa LK - https://open.uct.ac.za PY - 2020 T1 - Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country TI - Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country UR - ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s41927-020-00139-2
dc.identifier.urihttps://hdl.handle.net/11427/32079
dc.identifier.vancouvercitationSolomon A, Stanwix AE, Castañeda S, Llorca J, Gonzalez-Juanatey C, Hodkinson B, et al. Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country. BMC Rheumatology. 2020;4(1):42. .en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDivision of Rheumatologyen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Rheumatologyen_US
dc.source.journalissue1en_US
dc.source.journalvolume4en_US
dc.source.pagination42en_US
dc.source.urihttps://bmcrheumatol.biomedcentral.com/
dc.subjectCardiovascular disease risk managementen_US
dc.subjectRheumatoid arthritisen_US
dc.subjectLow to middle income countriesen_US
dc.subjectSouth Africaen_US
dc.titlePoints to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income countryen_US
dc.typeJournal Articleen_US
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