Prevention & lipidsCohort study

Comprehensive risk factor control attenuates excess cardiovascular risk in rheumatoid arthritis: a prospective cohort study

Eur J Prev CardiolPublished

  • Prospective cohort study
  • matched non-RA controls
  • UK Biobank

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

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

OutcomeHR (95% CI)
CVD, CHD and stroke, high control vs non-RA controls · stroke0.34 (0.13–0.91)

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:10.1093/eurjpc/zwag467

Summarised from the published abstract; every number is checked against it