World Arthritis Day: Bone Deformities, Diabetes And Other Risks Associated With Rheumatoid Arthritis

By conservative estimates, currently at least 5 million Indians are living with rheumatoid arthritis (RA)*. RA is an autoimmune condition that causes pain, inflammation and stiffness in the joints, especially those in the knees, wrists and fingers. In general, many people are aware that RA severely affects the joints and can lead to difficulty in movement and even disability. However, few realise that the impact of RA is not limited to the joints. Studies show that patients with RA are at a higher risk of developing comorbid conditions such as heart disease, diabetes, lung disease, nerves disease, skin ulcers, and dry eyes. According to one study** from India, 4 out of 10 Indian patients with RA had at least one comorbid condition in addition to RA.

World Arthritis Day: Risks associated with rheumatoid arthritis 

1. Hypertension and cardiovascular disease

Patients with RA produce excessive amounts of certain body chemicals that contribute to a low level of chronic inflammation throughout the body (also known as 'low grade, systemic inflammation'). This can lead to changes and stiffness in the blood vessels, resulting in high blood pressure. People with RA experience severe limitations in their movement and physical activity. This can cause them to become overweight or obese, which further increases blood pressure. Moreover, some drugs used to treat RA can also result in hypertension. This inflammation, lack of physical activity and increase in blood pressure also helps explain why those with RA have a 60% increase*** in the risk of mortality from cardiovascular disease.

Also read: Tips On Home Care And Lifestyle Changes For Rheumatoid Arthritis

2. Diabetes

Having diabetes increases the risk of developing RA and in turn, having RA increases the risk of developing diabetes. Once again, chronic inflammation is the culprit because it causes the cells of the body not to respond to insulin. Lack of physical activity, which can lead to obesity, increases a person's risk for diabetes. Moreover, some drugs such as steroids that are used to treat RA can also raise blood sugar.

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3. Lung disease

Lung disease may be the result of medication used to treat RA or because those with RA produce high levels of specific antibodies. While RA mostly affects women, lung disease is often seen in men who are in their 50s or 60s, have obvious symptoms of RA ('active disease') and a history of smoking. Patients with RA who experience symptoms such as shortness of breath, pain while breathing, dry cough or any other respiratory symptoms should speak to their doctor immediately.

There are many treatment options available today that help to manage RA, slow down the progression of the disease, limit disability and therefore extend a person's length and quality of life. However, a comorbid condition that is not diagnosed or treated can reverse all these benefits and shorten a person's life. This is why it is important for patients with RA to be aware of the possible complications, visit their rheumatologists regularly, and make the necessary lifestyle changes to reduce their risk.

Also read: 7 Most Effective Foods To Reduce Arthritis Symptoms Like Joint Pain And Swelling

* Chopra A et al. (2012). 5 Million Patients and Not 0.34% Is Worrisome: Burden of Rheumatoid Arthritis in India Based On a Bone and Joint Decade India Community Oriented Program for Control of Rheumatic Disease. S23-S23.

** Chandrashekara S et al. Comorbidities and related factors in rheumatoid arthritis patients of south India- Karnataka Rheumatoid Arthritis Comorbidity (KRAC) study. Reumatismo. 2017 Aug 3;69(2):47-58.

*** van Onna M, Boonen A. The challenging interplay between rheumatoid arthritis, ageing and comorbidities. BMC Musculoskelet Disord. 2016;17:184. Published 2016 Apr 26. doi:10.1186/s12891-016-1038-3

(Dr Lalit Duggal, HOD Rheumatology at Sir Ganga Ram Hospital)

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