Abstract
Objective Vascular pathology (changes in blood vessels) and osteoarthritis are both common chronic conditions associated with ageing and obesity, but whether vascular pathology is a risk factor for osteoarthritis is unclear. To systematically review the evidence for an association between vascular pathology and risk of joint specific osteoarthritis.
Methods Scopus, Ovid Medline and EMBASE were searched between January 1946 and February 2019. MeSH terms and key words were used to identify studies examining the association between vascular pathology and osteoarthritis. Two reviewers independently extracted the data and assessed the methodological quality. Qualitative evidence synthesis was performed.
Results Fifteen studies with high (n=3), fair (n=3) or low (n=9) quality were included. Features of vascular pathology included atherosclerosis, vascular stiffness, and endothelial dysfunction in different vascular beds. There was evidence for an association between vascular pathology and risk of hand osteoarthritis in women but not men, and between vascular pathology and risk of knee osteoarthritis in both men and women. Only two studies examined hip osteoarthritis showing no association between vascular pathology and risk of hip osteoarthritis.
Conclusion There is evidence suggesting an association between vascular pathology and risk of hand and knee osteoarthritis with a potential causal relationship for knee osteoarthritis. Based on the limited evidence, it is hard to conclude an association for hip osteoarthritis. Further stronger evidence is needed to determine whether there is a causal relationship.