TY - JOUR T1 - Cardiovascular Risk in Rheumatoid Arthritis (RA): Does It Matter If RA Is Diagnosed in Early or Late Age? JF - The Journal of Rheumatology JO - J Rheumatol SP - 1945 LP - 1947 DO - 10.3899/jrheum.131109 VL - 40 IS - 12 AU - KIMBERLY P. LIANG Y1 - 2013/12/01 UR - http://www.jrheum.org/content/40/12/1945.abstract N2 - Rheumatoid arthritis (RA) is a complex autoimmune disorder with heterogeneous clinical presentations, including age at disease onset. Indeed, RA can be diagnosed at any age. Although the peak age of onset is between 50 and 75 years, the prevalence of RA in females over age 65 is up to 5%1. Given the prevalence of RA is about 1% in whites2, there is a substantial subgroup of RA patients who are elderly (over age 65) at disease onset. There are over 50 countries with current life expectancies of 75 years or older3. Hence, the risk of morbidity and mortality even in the subgroup of elderly-onset RA patients is of clinical relevance.The approximately 2 to 3-fold increased risk of cardiovascular disease (CVD) in RA is well-established4,5,6. It is suggested that both traditional CV risk factors as well as RA-specific disease mechanisms (e.g., systemic inflammation, immune dysregulation, and premature immunosenescence) contribute to the overall CV risk in RA. However, few studies have examined the risks and determinants of CVD in subgroups of RA patients depending on their age at diagnosis. In a previous population-based study6, it was shown that the 10-year absolute cardiovascular (CV) risk in given age groups varied substantially according to the presence of CV risk factors; among 60 to 69-year-old RA patients with no risk factors, the absolute CV risk was only 16.8%, but rose to 60.4% if CV risk factors of smoking, hypertension (HTN), dyslipidemia, diabetes, and obesity were present. A recent study by Ajeganova and colleagues in this issue of The Journal7 complements these findings by examining the effect of early RA disease factors on CV risk, stratified by age at RA disease onset.Their study sought to examine the associations of … Address correspondence to Dr. Liang, University of Pittsburgh, Division of Rheumatology, 3500 Terrace St., BST S723, Pittsburgh, PA 15261, USA. E-mail: liangkp{at}upmc.edu ER -