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Home » Health Articles » I Have Rheumatoid Arthritis And Am Worried About Heart Attack Risk

I Have Rheumatoid Arthritis And Am Worried About Heart Attack Risk...

If you have rheumatoid arthritis, you should be worried about risk from cardiovascular events. That includes both heart attacks and strokes.

Women with rheumatoid arthritis (RA) have high rates of non fatal heart attacks. This occurs even without traditional risk factors being present. (Solomon, et al. Circulation 2003; 107: 1303-1307). The same is probably true for men with RA as well.

In addition multiple studies have demonstrated the increased risk of stroke occurring in patients with rheumatoid arthritis. Presence of intimal plaque (atherosclerosis in the inner walls of the carotid arteries) has been used as a surrogate marker of arterial disease elsewhere.

The conclusions drawn from multiple studies are that RA is an extremely potent risk factor for the development of atherosclerosis. More aggressive goals for risk factor modification should be instituted.

It's important to assess all risk factors in patients with RA. Control of hyperlipidemia and high blood pressure is mandatory. Dietary measures are primary. If dietary changes don't work, then statin therapy maybe needed. These drugs lower LDL cholesterol ("bad" cholesterol) and reduce levels of C-reactive protein. If a patient has diabetes, tight control of blood sugar is extremely important.

Discontinuation of cigarette smoking and proper weight management are important.

Rheumatoid arthritis (RA) patients could reduce their cardiovascular risk by spending more time walking.

Physical inactivity and sedentary behavior contribute to the risk of cardiovascular disease but little is known about energy expenditure from lifestyle physical activity in RA patients.

A recent study compared energy expenditure from exercise and lifestyle activities between 122 RA patients and 122 healthy controls.

At the beginning of the study, RA patients spent fewer kilocalories per week walking, exercising and participating in sports than did controls, the authors report.

Similar percentages of RA patients and controls met their recommended thresholds for total weekly energy expenditure, but the percent of RA patients meeting the recommended threshold for walking (32%) was notably lower than controls (48%).

At follow-up an average of 14 months later, RA patients continued to expend fewer kilocalories per week overall and were less likely to meet the threshold for walking, compared with controls.

"This study provides evidence that despite the fact that walking is an excellent lifestyle activity and it is markedly underutilized in RA patients," the authors note. "Our study supports the development and implementation of interventions to foster walking as part of a program to address cardiovascular risk in RA patients." (Mancuso C, et al. Arthritis Rheum 2007; 57:672-678).

Aspirin therapy has been shown to be effective prophylaxis for men and some studies also indicate its potential effectiveness in women.

In the final analysis, it must be mentioned that the most potent weapon against the increase in cardiovascular mortality is tight control of the rheumatoid arthritis- getting the disease into remission. Fortunately, the advent of first, second, and third generation biologic medicines have made this a reality.

And here is another random article you might be interested in...

How Do I Implement The Lease Purchase Plan?

Well, as we have discussed in previous newsletters first you have to set up goals for yourself, both long term and short term. Don't forget these goals define how your business is run. They will determine what you do on a daily, weekly and monthly basis. The best way to do this is to picture yourself a year down the road. Close your eyes and get a mental picture of where you want to be, what you want to have, how you want to look, then open your eyes and write all that down on paper or speak into a voice recorder.

First determine how much time you will have to work on your business. If you are starting part time or spare time and think you might have 5-7 hours per week, in reality you probably will have 2.5 to 3.5 hours per week. Whenever we ask a partnering student how much time they have I always cut the time they give me in half. Why? Well because things come up, such as children, obligations, illnesses, their other job, etc. So rather than kid yourself and set yourself up for failure before you even start, be realistic with the amount of time you will have.

Once you have determined how much time you have, make up a 12 month plan. For example if you only have 3 hours per week to work, that means in a 4 week month you have 12 hours. So realistically, the first month is going to be getting yourself set up. Getting your identity package done, your template letters done, your database set, your telephone script done, your research (networking, FSBO sites). You want to start collecting newspapers (remember 5 weeks and older). Your second month would be going through the newspapers, and going on line to those FSBO sites and collecting numbers. During the end of the second month (6 weeks after you have started) you should be able to start calling on property. Depending on the hours you are doing your calls will determine how many people you get to speak with as opposed to leaving a message for them. Months three and four you will continue your calls, set up a networking schedule and do deals with one particular strategy. After you feel comfortable with that strategy you can move on to the next one during months five and six. Months seven and eight should have you starting the next strategy, and the same goes for the remaining months (nine, ten, eleven and twelve). During months eleven and twelve you should do some evaluating of your goals for the year, and start thinking of where you want to go in year two. Be sure to write articles up for each deal and make note of things you did wrong (yes, you will make mistakes) and how you fixed them for subsequent deals.

Once you have your monthly plan set up, break that down in weekly goals, and then set up your daily goals to meet your weekly goals. If you don't meet some goals, don't beat yourself up. Look at the reasons why you didn't meet your goals for that particular day, week or month. Did other things get in the way (family, work, health issues) or did you just slack off. Sometimes you need to take a breather and come back with some fresh energy. So if you need a break once in a while take one.

However, you need to realize if you want to succeed you need to make a commitment to implementing the plan you set up. If this means missing some television shows, shopping spree, visiting with friends or some sleep; then that is what you have to do.

So start implementing the plan today!

Copyright DeFiore Enterprises 2003