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Clinical Articles, News & Views

Fitness level and CV risk in patients with rheumatoid arthritis

Maximal oxygen uptake (VO2max) levels are alarmingly low in rheumatoid arthritis (RA) patients, higher levels being associated with a better cardiovascular (CV) profile in this population, according to a study published recently in Rheumatology.1

Authors from the University of Wolverhampton assessed a total of 150 RA patients for cardiorespiratory fitness with a VO2max test and, based on this, they were split into three groups using the 33rd (18.1 ml/kg/min) and 66th (22.4 ml/kg/min) centiles. Classical and novel cardiovascular disease (CVD) risk factors [blood pressure, body fat, insulin resistance, cholesterol, triglycerides, high-density lipoprotein (HDL), physical activity, C-reactive protein (CRP), fibrinogen and white cell count], 10-year CVD risk, disease activity (DAS28) and severity (HAQ) were assessed in all cases.

Mean VO2max for all RA patients was 20.9 (S.D. 5.7) ml/kg/min. The 10-year CVD risk (P = 0.003), systolic blood pressure (P = 0.039), HDL (P = 0.017), insulin resistance and body fat (both at P<0.001), CRP (P = 0.005), white blood cell count (P = 0.015) and fibrinogen (P<0.001) were significantly different between the VO2max tertiles favouring the group with the higher VO2max levels. In multivariate analyses of variance, VO2max was significantly associated with body fat (P<0.001), HDL (P = 0.007), insulin resistance (P<0.003) and 10-year CVD risk (P<0.001), even after adjustment for DAS28, HAQ and physical activity.

Future studies need to focus on developing effective behavioural interventions to improve cardiorespiratory fitness in RA, say the authors.


1. Metsios GS, Koutedakis Y, Veldhuijzen van Zanten JJCS, et al. Rheumatology 2015;54:2215–20.

Published on: November 24, 2015

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