scholarly journals Cardiovascular risk management in rheumatoid arthritis: are we still waiting for the first step?

2013 ◽  
Vol 15 (2) ◽  
pp. 111 ◽  
Author(s):  
Mike JL Peters ◽  
Michael T Nurmohamed
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Management ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Management

Assessment of six cardiovascular risk calculators in Mexican mestizo patients with rheumatoid arthritis according to the EULAR 2015/2016 recommendations for cardiovascular risk management

2017 ◽  
Vol 36 (6) ◽  
pp. 1387-1393 ◽  
Author(s):  
Dionicio A. Galarza-Delgado ◽  
Jose R. Azpiri-Lopez ◽  
Iris J. Colunga-Pedraza ◽  
Jesus A. Cardenas-de la Garza ◽  
Raymundo Vera-Pineda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Management ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Management ◽  
Mexican Mestizo

scholarly journals Methotrexate and Vasculoprotection: Mechanistic Insights and Potential Therapeutic Applications in Old Age

2019 ◽  
Vol 25 (39) ◽  
pp. 4175-4184 ◽  
Author(s):  
Arduino A. Mangoni ◽  
Sara Tommasi ◽  
Angelo Zinellu ◽  
Salvatore Sotgia ◽  
Stefania Bassu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Risk Management ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Old Age ◽  
Human Model ◽  
Older Population ◽  
Cardiovascular Risk Management ◽  
Vascular Homeostasis

Increasing age is a strong, independent risk factor for atherosclerosis and cardiovascular disease. Key abnormalities driving cardiovascular risk in old age include endothelial dysfunction, increased arterial stiffness, blood pressure, and the pro-atherosclerotic effects of chronic, low-grade, inflammation. The identification of novel therapies that comprehensively target these alterations might lead to a major breakthrough in cardiovascular risk management in the older population. Systematic reviews and meta-analyses of observational studies have shown that methotrexate, a first-line synthetic disease-modifying anti-rheumatic drug, significantly reduces cardiovascular morbidity and mortality in patients with rheumatoid arthritis, a human model of systemic inflammation, premature atherosclerosis, and vascular aging. We reviewed in vitro and in vivo studies investigating the effects of methotrexate on endothelial function, arterial stiffness, and blood pressure, and the potential mechanisms of action involved. The available evidence suggests that methotrexate might have beneficial effects on vascular homeostasis and blood pressure control by targeting specific inflammatory pathways, adenosine metabolism, and 5' adenosine monophosphate-activated protein kinase. Such effects might be biologically and clinically relevant not only in patients with rheumatoid arthritis but also in older adults with high cardiovascular risk. Therefore, methotrexate has the potential to be repurposed for cardiovascular risk management in old age because of its putative pharmacological effects on inflammation, vascular homeostasis, and blood pressure. However, further study and confirmation of these effects are essential in order to adequately design intervention studies of methotrexate in the older population.

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