Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country

dc.contributor.authorSolomon, Ahmed
dc.contributor.authorStanwix, Anne E.
dc.contributor.authorCastaneda, Santos
dc.contributor.authorLlorca, Javier
dc.contributor.authorGonzalez-Juanatey, Carlos
dc.contributor.authorHodkinson, Bridget
dc.contributor.authorRomela, Benitha
dc.contributor.authorAlly, Mahmood Moosa Tar Mahomed
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.accessioned2021-02-25T14:36:27Z
dc.date.available2021-02-25T14:36:27Z
dc.date.issued2020-06
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_ZA
dc.description.departmentInternal Medicineen_ZA
dc.description.librarianpm2021en_ZA
dc.description.sponsorshipSouth African Arthritis and Rheumatology Association and Fondo de Investigaciones Sanitarias.en_ZA
dc.description.urihttps://bmcrheumatol.biomedcentral.comen_ZA
dc.identifier.citationSolomon, A., Stanwix, A.E., Castañeda, S. 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', BMC Rheumatology, vol. 4, no. 1, art. 42, pp. 1-16.en_ZA
dc.identifier.issn2520-1026 (online)
dc.identifier.other10.1186/s41927-020-00139-2
dc.identifier.urihttp://hdl.handle.net/2263/78847
dc.language.isoenen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.en_ZA
dc.subjectRheumatoid arthritisen_ZA
dc.subjectSouth Africa (SA)en_ZA
dc.subjectCardiovascular disease (CVD)en_ZA
dc.subjectRisk managementen_ZA
dc.subjectLow- and middle-income countries (LMICs)en_ZA
dc.titlePoints to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income countryen_ZA
dc.typeArticleen_ZA

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