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    RA, Hypertension, and Vascular Disease: What's True?

    Although rheumatoid arthritis (RA) is identified and defined primarily by its joint complications, I submit that it is a disease in need of contemporary reframing. Patients with RA have a substantively increased risk of myriad cardiovascular diseases. When did you last have reason to consider the cardiovascular accompaniments of RA? Try these 2 very short tests of your current knowledge.

    Which of the following statements is/are true?

    A. Patients with RA have both increased carotid intima media thickness as well as a higher annual rate of increasing carotid intima thickness than patients without RA.

    B. The prevalence of peripheral vascular disease is twice as high in patients with RA as age-matched controls without RA.

    C. Coronary artery calcification and abdominal aortic calcification are more frequent and more severe in patients with RA than in age-matched controls.

    D. A decreased GFR is relatively common in RA and is associated with hypertension.

    Answer, discussion, and next question, next page>>

    Gregory W. Rutecki, MD
    Dr Rutecki is with the Cleveland Clinic National Consultation Service.

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