Cardiovascular Disease in Inflammatory Joint Disorders: The interplay between risk factors, inflammation and therapy

Scope of this thesis In this thesis the cardiovascular disease (CVD) risk in inflammatory joint diseases (IJD) was investigated, focusing on rheumatoid arthritis (RA) and psoriatic arthritis (PsA). We aimed to create awareness of this high CVD risk by investigating the magnitude of CVD prevalence in IJD patients over the last decades, also considering new treatment modalities such as biological disease modifying antirheumatic drugs (bDMARD) and imaging techniques such as 18-fluorodeoxyglucose positron emission tomography combined with computed tomography (18F-FDG-PET/CT). In addition, traditional and novel risk factors for CVD and the effects of anti-inflammatory therapy on these risk factors were assessed. Lastly, we revised new EULAR recommendations for CVD risk management in IJD and proposed ideas for future research. Conclusion Atherosclerosis is an inflammatory process, which is further enhanced by the chronic inflammation inherent to IJD. This has implications for health care professionals, especially rheumatologists and cardiologists, but IJD patients should also be aware of their increased CVD risk and take timely precautions. Acknowledging this high risk is an important step preceding the implementation of strategies for prediction, prevention and management of CVD in IJD. There lies an evidence gap which needs to be filled in the future and general practice guidelines need to be developed to reduce CVD risk in these patients.