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Among the many challenges you face as a patient with rheumatoid arthritis (RA) is the fact that you have a higher risk of developing heart disease -- almost twice the risk for individuals without RA. Moreover, heart disease is a leading cause of death among patients with RA.

The inflammation that underlies your RA can lead to the build-up of plaque in the arteries, causing narrowing of the blood vessels and can ultimately result in events such as heart attack and stroke.

Other factors that can contribute to your heart risks include high blood pressure, abnormalities in levels of cholesterol -- particularly the "bad" cholesterol known as low-density lipoprotein cholesterol -- and obesity. Because it can be difficult to exercise with sore joints, RA patients often gain weight, which can worsen other factors including blood pressure and high levels of blood sugar.

Smoking is a particular risk, and has actually been linked as a trigger for the onset of RA. Smoking has been linked with a more severe course of disease, worse effects on the arteries, and irreversible damage to your joints. In fact, the Arthritis Foundation has reported that the risk of cardiovascular events is 50% higher among RA patients who smoke compared with nonsmoking RA patients.

Limiting Your Risks

There are many things you can do to help stay heart healthy. One is by carefully adhering to the medication plan you formulate with your rheumatologist, whether the treatment is methotrexate, a biologic, or another type of drug.

Lifestyle changes certainly can help. Regular exercise and following a healthy diet such as the Mediterranean diet can help you lose weight and limit inflammation. Regular exercise is important for everyone, but particularly for patients with RA.

The Arthritis Foundation has designed a that is available at community centers and YMCAs, and which focuses on improving function, mobility, strength, and coordination with the goal of improving the pain, stiffness, and fatigue associated with RA.

Quitting smoking is also very important, and your doctor may suggest measures to help such as nicotine replacement and counseling.

You should also have regular monitoring of your blood pressure, blood sugar, and cholesterol levels. Early intervention can be most beneficial if you begin to develop these problems.

Be sure to let your physician know right away if you develop any potential symptoms of heart disease, such as chest pain or shortness of breath.

Read previous installments in this series:

What Is Rheumatoid Arthritis?

How Is Rheumatoid Arthritis Diagnosed?

Starting Treatment for Rheumatoid Arthritis

Beyond the First RA Treatments

Special Concerns About COVID

Reproductive Health in RA

How to Cope With Rheumatoid Arthritis

"Medical Journeys" is a set of clinical resources reviewed by doctors, meant for physicians and other healthcare professionals as well as the patients they serve. Each episode of this 12-part journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.