Comprehensive risk factor control attenuates excess cardiovascular risk in rheumatoid arthritis: a prospective cohort study
Authors' conclusion
Comprehensive control attenuates and may offset RA-excess CVD risk, even with high genetic susceptibility. The effect is partially metabolically mediated yet independent of metabolic status, supporting dual-pathway prevention.
Study context
- Population
- Patients with rheumatoid arthritis, UK Biobank4,426 rheumatoid arthritis (RA) patients
- Exposure
- High or moderate vs low risk factor control score
- Non-RA controlsn = 17,704
- Outcome
- Incident CVD
Methodological detailsmatched non-RA controls, UK Biobank
- Matched non-RA controls
- UK Biobank
Main finding
As reported in the abstract
Each group vs low controlHazard ratio (95% CI)
Moderate control
0.77(0.64–0.93)
High control
0.46(0.33–0.64)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| CVD, CHD and stroke, high controlvs non-RA controlsStroke | 0.34 (0.13–0.91) | |
| 0.10.31310Hazard ratio (log scale) |
Cardiovascular disease (CVD), coronary heart disease (CHD) and stroke, high control vs non-RA controls
- High control: CVD and CHD risks comparable to non-RA controls
CVD-free years (restricted mean survival time (RMST))
- RMST: CVD-free years gained
- +3.58
- 95% CI 2.49-4.68
- P < 0.001
Mediation by metabolomic risk score (MRS)
- Partial MRS mediation, indirect proportion
- 34.1%
- Indirect proportion, adjusted
- 20.8%
Effect modification by MRS and genetic risk
- No significant interaction with MRS
- High control attenuated risk even in high genetic risk
Original publication
Comprehensive risk factor control attenuates excess cardiovascular risk in rheumatoid arthritis: a prospective cohort study. Eur J Prev Cardiol. Published 5 September 2026. doi:10.
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