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Ann Rheum Dis. 2015 Jan;74(1):74-81. doi: 10.1136/annrheumdis-2013-203789. Epub 2013 Sep 18.

Hand osteoarthritis in relation to mortality and incidence of cardiovascular disease: data from the Framingham heart study.

Author information

  • 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
  • 2Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Cardiology, Boston University School of Medicine, Boston, Massachusetts, USA.
  • 3Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA.

Abstract

OBJECTIVES:

To study whether hand osteoarthritis (OA) is associated with increased mortality and cardiovascular events in a large community based cohort (Framingham Heart Study) in which OA, mortality and cardiovascular events have been carefully assessed.

METHODS:

We examined whether symptomatic (≥1 joint(s) with radiographic OA and pain in the same joint) and radiographic hand OA (≥1 joint(s) with radiographic OA without pain) were associated with mortality and incident cardiovascular events (coronary heart disease, congestive heart failure and/or atherothrombotic brain infarction) using Cox proportional hazards models. In the adjusted models, we included possible confounding factors from baseline (eg, metabolic factors, medication use, smoking/alcohol). We also adjusted for the number of painful joints in the lower limb and physical inactivity.

RESULTS:

We evaluated 1348 participants (53.8% women) with mean (SD) age of 62.2 (8.2) years, of whom 540 (40.1%) and 186 (13.8%) had radiographic and symptomatic hand OA, respectively. There was no association between hand OA and mortality. Although there was no significant relation to incident cardiovascular events overall or a relation of radiographic hand OA with events, we found a significant association between symptomatic hand OA and incident coronary heart disease (myocardial infarction/coronary insufficiency syndrome) (HR 2.26, 95% CI 1.22 to 4.18). The association remained after additional adjustment for pain in the lower limb or physical inactivity.

CONCLUSIONS:

Symptomatic hand OA, but not radiographic hand OA, was associated with an increased risk of coronary heart disease events. The results suggest an effect of pain, which may be a possible marker of inflammation.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

KEYWORDS:

Cardiovascular Disease; Epidemiology; Hand Osteoarthritis; Osteoarthritis

PMID:
24047870
[PubMed - indexed for MEDLINE]
PMCID:
PMC3959628
[Available on 2016-01-01]
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