PT - JOURNAL ARTICLE AU - Inger Jorid Berg AU - Désirée van der Heijde AU - Hanne Dagfinrud AU - Ingebjørg Seljeflot AU - Inge Christoffer Olsen AU - Tore K. Kvien AU - Anne Grete Semb AU - Sella A. Provan TI - Disease Activity in Ankylosing Spondylitis and Associations to Markers of Vascular Pathology and Traditional Cardiovascular Disease Risk Factors: A Cross-sectional Study AID - 10.3899/jrheum.141018 DP - 2015 Feb 01 TA - The Journal of Rheumatology PG - jrheum.141018 4099 - http://www.jrheum.org/content/early/2015/01/27/jrheum.141018.short 4100 - http://www.jrheum.org/content/early/2015/01/27/jrheum.141018.full AB - Objective To compare the risk of cardiovascular disease (CVD) in ankylosing spondylitis (AS) and population controls, and to examine the associations between disease activity and CVD risk. Methods A cross-sectional study was done of patients with AS grouped according to Ankylosing Spondylitis Disease Activity Score (ASDAS) into ASDAS-high and ASDAS-low. Markers of vascular pathology, impaired endothelial function [asymmetric dimethylarginine (ADMA)], and arterial stiffness [augmentation index (AIx) and pulse wave velocity (PWV)], and traditional CVD risk factors [blood pressure, lipids, body mass index (BMI), CVD risk scores] were compared between AS and controls as well as across ASDAS-high versus ASDAS-low versus controls using ANCOVA analyses. Results Altogether, 151 patients with AS and 134 controls participated. Patients had elevated ADMA (μmol/l) and AIx (%) compared to controls: mean difference (95% CI): 0.05 (0.03, 0.07), p < 0.001 and 2.6 (0.8, 4.3), p = 0.01, respectively. AIx increased with higher ASDAS level, p(trend) < 0.04. There were no significant group differences of PWV. BMI was higher in ASDAS-high compared to ASDAS-low (p = 0.02). Total cholesterol was lower in AS compared to controls, and lower with higher ASDAS, p(trend) = 0.02. CVD risk scores were similar across groups except for Reynolds Risk Score, where the ASDAS-high group had a significantly higher score, compared to both ASDAS-low and controls. Conclusion Elevated ADMA and AIx in AS support a higher CVD risk in AS. Elevated AIx and BMI in AS with high ASDAS indicate an association between disease activity and CVD risk. Lower total cholesterol in AS may contribute to underestimation of CVD risk.