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Prognostic importance of low body mass index in relation to cardiovascular mortality in rheumatoid arthritis.
Arthritis Rheum. 2004 Nov; 50(11):3450-7.AR

Abstract

OBJECTIVE

Various etiologic mechanisms have been implicated in the observed increase in cardiovascular mortality in rheumatoid arthritis (RA). Body mass index (BMI) is associated with cardiovascular mortality in the general population. This study compared the effect of BMI on cardiovascular mortality in a population-based cohort of subjects with RA with that in a cohort of individuals without RA from the same population.

METHODS

The RA cohort comprised all members of an incidence cohort of Rochester, Minnesota residents ages > or =18 years who were first diagnosed with RA (by the American College of Rheumatology 1987 criteria) from 1955 through 1994. An age- and sex-matched comparison cohort of subjects without RA was assembled. Both cohorts were followed up longitudinally through their complete (inpatient, outpatient) medical records beginning at age 18 years and continuing until death, migration, or January 1, 2001, and the details of weight and height changes during this period were recorded. High BMI was defined as a BMI >30 kg/m(2) and low BMI as <20 kg/m(2). Cox regression models were used to estimate the effect of BMI on cardiovascular mortality after accounting for traditional cardiac risk factors and malignancies.

RESULTS

RA subjects with low BMI at incidence had a significantly higher risk of cardiovascular death (hazard ratio [HR] 3.34, 95% confidence interval [95% CI] 2.23-4.99) compared with non-RA subjects with normal BMI, after adjusting for age, sex, personal cardiac history, smoking status, and presence of diabetes, hypertension, and malignancies. RA subjects with normal BMI at incidence who experienced low BMI during followup also had a higher risk of cardiovascular death (HR 2.09, 95% CI 1.50-2.92) when compared with non-RA subjects who maintained normal BMI throughout followup.

CONCLUSION

Among patients with RA, low BMI is associated with a significantly increased risk of cardiovascular death.

Authors+Show Affiliations

Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15529378

Citation

Kremers, Hilal Maradit, et al. "Prognostic Importance of Low Body Mass Index in Relation to Cardiovascular Mortality in Rheumatoid Arthritis." Arthritis and Rheumatism, vol. 50, no. 11, 2004, pp. 3450-7.
Kremers HM, Nicola PJ, Crowson CS, et al. Prognostic importance of low body mass index in relation to cardiovascular mortality in rheumatoid arthritis. Arthritis Rheum. 2004;50(11):3450-7.
Kremers, H. M., Nicola, P. J., Crowson, C. S., Ballman, K. V., & Gabriel, S. E. (2004). Prognostic importance of low body mass index in relation to cardiovascular mortality in rheumatoid arthritis. Arthritis and Rheumatism, 50(11), 3450-7.
Kremers HM, et al. Prognostic Importance of Low Body Mass Index in Relation to Cardiovascular Mortality in Rheumatoid Arthritis. Arthritis Rheum. 2004;50(11):3450-7. PubMed PMID: 15529378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic importance of low body mass index in relation to cardiovascular mortality in rheumatoid arthritis. AU - Kremers,Hilal Maradit, AU - Nicola,Paulo J, AU - Crowson,Cynthia S, AU - Ballman,Karla V, AU - Gabriel,Sherine E, PY - 2004/11/6/pubmed PY - 2004/12/18/medline PY - 2004/11/6/entrez SP - 3450 EP - 7 JF - Arthritis and rheumatism JO - Arthritis Rheum VL - 50 IS - 11 N2 - OBJECTIVE: Various etiologic mechanisms have been implicated in the observed increase in cardiovascular mortality in rheumatoid arthritis (RA). Body mass index (BMI) is associated with cardiovascular mortality in the general population. This study compared the effect of BMI on cardiovascular mortality in a population-based cohort of subjects with RA with that in a cohort of individuals without RA from the same population. METHODS: The RA cohort comprised all members of an incidence cohort of Rochester, Minnesota residents ages > or =18 years who were first diagnosed with RA (by the American College of Rheumatology 1987 criteria) from 1955 through 1994. An age- and sex-matched comparison cohort of subjects without RA was assembled. Both cohorts were followed up longitudinally through their complete (inpatient, outpatient) medical records beginning at age 18 years and continuing until death, migration, or January 1, 2001, and the details of weight and height changes during this period were recorded. High BMI was defined as a BMI >30 kg/m(2) and low BMI as <20 kg/m(2). Cox regression models were used to estimate the effect of BMI on cardiovascular mortality after accounting for traditional cardiac risk factors and malignancies. RESULTS: RA subjects with low BMI at incidence had a significantly higher risk of cardiovascular death (hazard ratio [HR] 3.34, 95% confidence interval [95% CI] 2.23-4.99) compared with non-RA subjects with normal BMI, after adjusting for age, sex, personal cardiac history, smoking status, and presence of diabetes, hypertension, and malignancies. RA subjects with normal BMI at incidence who experienced low BMI during followup also had a higher risk of cardiovascular death (HR 2.09, 95% CI 1.50-2.92) when compared with non-RA subjects who maintained normal BMI throughout followup. CONCLUSION: Among patients with RA, low BMI is associated with a significantly increased risk of cardiovascular death. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/15529378/Prognostic_importance_of_low_body_mass_index_in_relation_to_cardiovascular_mortality_in_rheumatoid_arthritis_ L2 - https://doi.org/10.1002/art.20612 DB - PRIME DP - Unbound Medicine ER -