Subscribe to RSS
DOI: 10.1055/s-2007-963223
© Georg Thieme Verlag KG Stuttgart · New York
Entzündlich-rheumatische Erkrankungen und kardiovaskuläres Risiko: ernährungsmedizinische Aspekte
Inflammatory Rheumatic Diseases and Cardiovascular Risks: Aspects of Nutritional MedicinePublication History
Publication Date:
04 September 2007 (online)

Zusammenfassung
Chronische Entzündung ist ein unabhängiger Risikofaktor für kardiovaskuläre Komplikationen bei rheumatischen Erkrankungen. Die erhöhte Mortalität kann durch eine effektive Krankheitskontrolle reduziert werden. Ernährungsmedizinische Ansätze zielen auf die Prävention und Therapie traditioneller kardiovaskulärer Risikofaktoren wie arterielle Hypertonie, Adipositas oder Hyperlipoproteinämie, können aber auch unmittelbar zur Senkung der Entzündungsaktivität beitragen.
Abstract
Chronic inflammation is an independent risk factor for cardiovascular comorbidity in rheumatic diseases. Effective disease-modifying drugs reduce this increased mortality. The targets of nutritional interventions are not only the traditional risk factors such as hypertension, obesity or hyperlipoproteinemia but also to achieve a reduction of the inflammation.
Schlüsselwörter
Entzündlich-rheumatische Erkrankungen - rheumatoide Arthritis - kardiovaskuläres Risiko - Komorbidität - Mortalität - Ernährung - Ernährungsmedizin - Diät
Key words
rheumatic diseases - rheumatoid arthritis - cardiovascular risks - comorbidity - mortality - nutrition - nutritional medicine - diet
Literatur
- 1
Isomäki H A, Mutru O, Koota K.
Death rate and causes of death in patients with rheumatoid arthritis.
Scand J Rheumatol.
1975;
4
205-208
MissingFormLabel
- 2
Prior P, Symmons D P, Scott D L. et al .
Cause of death in rheumatoid arthritis.
Br J Rheumatol.
1984;
23
92-99
MissingFormLabel
- 3
Mutru O, Laakso M, Isomaki H. et al .
Ten year mortality and causes of death in patients with rheumatoid arthritis.
Br Med J (Clin Res Ed).
1985;
290
1797-1799
MissingFormLabel
- 4
Mitchell D M, Spitz P W, Young D Y. et al .
Survival, prognosis, and causes of death in rheumatoid arthritis.
Arthritis Rheum.
1986;
29
706-714
MissingFormLabel
- 5
Pinals R S.
Survival in rheumatoid arthritis.
Arthritis Rheum.
1987;
30
473-475
MissingFormLabel
- 6
Wolfe F, Mitchell D M, Sibley J T. et al .
The mortality of rheumatoid arthritis.
Arthritis Rheum.
1994;
37
481-94
MissingFormLabel
- 7
Riise T, Jacobsen B K, Gran J T. et al .
Total mortality is increased in rheumatoid arthritis. A 17-year prospective study.
Clin Rheumatol.
2001;
20
123-127
MissingFormLabel
- 8
Watson D J, Rhodes T, Guess H A.
All-cause mortality and vascular events among patients with rheumatoid arthritis,
osteoarthritis, or no arthritis in the UK General Practice Research Database.
J Rheumatol.
2003;
30
1196-1202
MissingFormLabel
- 9
Goodson N J, Wiles N J, Lunt M. et al .
Mortality in early inflammatory polyarthritis: cardiovascular mortality is increased
in seropositive patients.
Arthritis Rheum.
2002;
46
2010-2019
MissingFormLabel
- 10
Solomon D H, Karlson E W, Rimm E B. et al .
Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis.
Circulation.
2003;
107
1303-1307
MissingFormLabel
- 11
del Rincon I, Williams K, Stern M P. et al .
High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained
by traditional cardiac risk factors.
Arthritis Rheum.
2001;
44
2737-2745
MissingFormLabel
- 12
Gabriel S E, Crowson C S, Kremers H M. et al .
Survival in rheumatoid arthritis: a population-based analysis of trends over 40 years.
Arthritis Rheum.
2003;
48
54-58
MissingFormLabel
- 13
Maradit-Kremers H, Crowson C S, Nicola P J. et al .
Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis:
a population-based cohort study.
Arthritis Rheum.
2005;
52
402-411
MissingFormLabel
- 14
Soubrier M, Zerkak D, Dougados M.
Indications for Lowering LDL Cholesterol in Rheumatoid Arthritis: An Unrecognized
Problem.
J Rheumatol.
2006;
33
1766-1769
MissingFormLabel
- 15
Bessant R, Duncan R, Ambler G. et al .
Prevalence of conventional and lupus-specific risk factors for cardiovascular disease
in patients with systemic lupus erythematosus: A case-control study.
Arthritis Rheum.
2006;
55
892-899
MissingFormLabel
- 16
De Leeuw K, Freire B, Smit A J. et al .
Traditional and non-traditional risk factors contribute to the development of accelerated
atherosclerosis in patients with systemic lupus erythematosus.
Lupus.
2006;
15
675-682
MissingFormLabel
- 17
Maksimovicz-McKinnon K, Magder L S, Petri M.
Predictors of Carotid Atherosclerosis in Systemic Lupus Erythematosus.
J Rheumatol.
2006;
33
2458-2463
MissingFormLabel
- 18
De Leeuw K, Sanders J S, Stegeman C. et al .
Accelerated atherosclerosis in patients with Wegener’s granulomatosis.
Annals of the Rheumatic Diseases.
2005;
64
753-759
MissingFormLabel
- 19
Han C, Robinson D W, Hackett M V. et al .
Cardiovascular Disease and Risk Factors in Patients with Rheumatoid Arthritis, Psoriatic
Arthritis, and Ankylosing Spondylitis.
J Rheumatol.
2006;
33
2167-2172
MissingFormLabel
- 20
Solomon D H. et al .
Patterns of cardiovascular risk In rheumatoid arthritis.
Ann Rheum Dis.
2006;
65
1608-1612
MissingFormLabel
- 21
Yalamanchili Jr K, Aronow W S, Kilaru R. et al .
Coronary Artery Disease Is More Severe in Older Persons With Rheumatoid Arthritis
Than in Older Persons Without Rheumatoid Arthritis.
Cardiology in Review.
2006;
14
55-56
MissingFormLabel
- 22
Esdaile J M, Abrahamowicz M, Grodzicky T. et al .
Traditional Framingham risk factors fail to fully account for accelerated atherosclerosis
in systemic lupus erythematosus.
Arthritis Rheum.
2001;
44 (10)
2331-2337
MissingFormLabel
- 23
Björnådal L, Brandt L, Klareskog L. et al .
Impact of parental history on patients’ cardiovascular mortality in rheumatoid arthritis.
Annals of the Rheumatic Diseases.
2006;
65
741-745
MissingFormLabel
- 24
Wallberg-Jonsson S. et al .
Extent of inflammation predicts cardiovascular disease and overall mortality in seropositive
rheumatoid arthritis. A retrospective cohort study from disease onset.
J Rheumatol.
1999;
26
2562-2571
MissingFormLabel
- 25
Liang K P. et al .
Mayo Clinic and Mayo Graduate School of Medicine, Rochester, Minnesota: Incidence
of noncardiac vascular disease in rheumatoid arthritis and relationship to extraarticular
disease manifestations.
Arthritis Rheum.
2006;
54 (2)
642-648
MissingFormLabel
- 26
Turesson C, McClelland R L, Christianson T J. et al .
Severe extra-articular disease manifestations are associated with an increased risk
of first ever cardiovascular events in patients with rheumatoid arthritis.
Ann Rheum Dis.
2007;
66
70-75
MissingFormLabel
- 27
Roman M J, Moeller E, Davis A. et al .
Preclinical Carotid Atherosclerosis in Patients with Rheumatoid Arthritis.
Annals of Internal Medicine.
2006;
144
249-256
MissingFormLabel
- 28
del Rincon I, Freeman G L, Haas R W. et al .
Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical
manifestations to atherosclerosis.
Arthritis Rheum.
2005;
52 (11)
3413-3423
MissingFormLabel
- 29
Del Rincon I, O’leary D H, Freeman G L. et al .
Acceleration of atherosclerosis during the course of rheumatoid arthritis.
Atherosclerosis.
2006;
9
Epub ahead of print
MissingFormLabel
- 30
Boers M, Nurmohamed M T, Doelman C J. et al .
Influence of glucocorticoid and disease activity on total and high density lipoprotein
cholesterol in patients with rheumatoid arthritis.
Ann Rheum Dis.
2003;
62
842-845
MissingFormLabel
- 31
Situnayake R, Kitas G.
Dyslipidemia and rheumatoid arthritis.
Ann Rheum Dis.
1997;
56
341-342
MissingFormLabel
- 32
Park Y B, Lee S K, Lee W K. et al .
Lipid profiles in untreated patients with rheumatoid arthritis.
J Rheumatol.
1999;
26
1701-1704
MissingFormLabel
- 33
Lorber M, Aviram M, Linn S. et al .
Hypocholesterolaemia and abnormal high-density lipoprotein in rheumatoid arthritis.
r J Rheumatol.
1985;
24
250-255
MissingFormLabel
- 34
Frati E, Castagna M L, Bacarelli M R. et al .
Plasma levels of apolipoprotein and HDL-cholesterol in patients with rheumatoid arthritis.
Boll Soc Ital Biol Sper.
1984;
60
1791-1796
MissingFormLabel
- 35
Lazarevic M B, Vitic J, Mladenovic V. et al .
Dyslipoproteinemia in the course of active rheumatoid arthritis.
Semin Arthritis Rheum.
1992;
22
172-178
MissingFormLabel
- 36
Georgiadis A N, Papavasiliou E C, Lourida E S. et al .
Atherogenic Lipid Profile is a Feature Characteristic of Patients With Early Rheumatoid
Arthritis: Effect of Early Treatment - A Prospective, Controlled Study.
Arthritis Res Ther.
2006;
8 (3): R82. Epub 2006 Apr 28
, http://arthritis-research.com/content/8/3/R82
MissingFormLabel
- 37
Halm V P, Nielen M M, Nurmohamed M T. et al .
Lipids and inflammation: serial measurements of the lipid profile of blood donors
who later developed rheumatoid arthritis.
Annals of the Rheumatic Diseases.
2007;
66
184-188
MissingFormLabel
- 38
McCarey D W, McInnes I B, Madhok van R. et al .
Trial of atorvastatin in rheumatoid arthritis (TARA): double-blind, randomized, placebo-controlled
trial.
Lancet.
2004;
363
2015-1021
MissingFormLabel
- 39
Riboldi P, Gerosa M, Meroni P L.
Statins and autoimmune diseases.
Lupus.
2005;
14
765-768
MissingFormLabel
- 40
Penney C J.
Statins in rheumatology.
J Rheumatol.
2005;
32
17-19
MissingFormLabel
- 41
Nagashima T, Okazaki H, Yudoh K. et al .
Apoptosis of rheumatoid synovial cells by statins through the blocking of protein
geranylgeranylation: A potential therapeutic approach to rheumatoid arthritis.
Arthritis Rheum.
2006;
54 (2)
579-586
MissingFormLabel
- 42
Xu H, Liu P, Liang L. et al .
RhoA-mediated, tumor necrosis factor alpha-induced activation of NF-kappaB in rheumatoid
synoviocytes: inhibitory effect of simvastatin.
Arthritis Rheum.
2006;
54 (11)
3441-3451
MissingFormLabel
- 43
Choi H K, Hernan M A, Seeger J D. et al .
Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study.
Lancet.
2002;
359
1173-1177
MissingFormLabel
- 44
Halm V P, Nurmohamed M T, Twisk J WR. et al .
Disease-modifying antirheumatic drugs are associated with a reduced risk for cardiovascular
disease in patients with rheumatoid arthritis: a case control study.
Research & Therapy.
2006;
8
R151
MissingFormLabel
- 45
Jacobsson L T, Turesson van C, Gülfe A. et al .
Treatment with tumor necrosis factor blockers is associated with a lower incidence
of first cardiovascular events in patients with rheumatoid arthritis.
J Rheumatol.
2005;
32
1213-1218
MissingFormLabel
- 46
Jacobsson L T, Turesson C, Nilsson J A. et al .
Treatment with TNF-blockers and mortality risk in patients with rheumatoid arthritis.
Ann Rheum Dis.
2006;
11
Epub ahead of print
, http://ard.bmj.com/cgi/content/abstract/ard.2006.062497v1
MissingFormLabel
- 47
Bilsborough W, Keen H, Taylor A. et al .
Anti-tumour necrosis factor-alpha therapy over conventional therapy improves endothelial
function in adults with rheumatoid arthritis.
Rheumatol Int.
2006;
26 (12)
1125-1131
MissingFormLabel
- 48
Dixon W G, Symmons D PM.
What effects might anti-TNF-alpha-therapy be expected to have on cardiovascular morbidity
and mortality in rheumatoid arthritis? A review of the role of TNF-alpha in cardiovascular
pathophysiology.
Ann Rheum Dis.
2007;
24
Epub ahead of print
, http://ard.bmj.com/cgi/content/abstract/ard.2006.063867v1
MissingFormLabel
- 49
Boers M, Nurmohamed M T, Doelman C J. et al .
Influence of glucocorticoids and disease activity on total and high density lipoprotein
cholesterol in patients with rheumatoid arthritis.
Ann Rheum Dis.
2003;
62
842-845
MissingFormLabel
- 50
Spanakis E, Sidiropoulos P, Papadakis J. et al .
Modest But Sustained Increase of Serum High Density Lipoprotein Cholesterol Levels
in Patients with Inflammatory Arthritides Treated with Infliximab.
J Rheumatol.
2006;
33 (12)
2440-2446
MissingFormLabel
- 51
Kiortsis D N, Mavridis A K, Filippatos T D. et al .
Effects of infliximab treatment on lipoprotein profile in patients with rheumatoid
arthritis and ankylosing spondylitis.
J Rheumatol.
2006;
33 (5)
921-923
MissingFormLabel
- 52
Popa C, Netea M G, Radstake T. et al .
Influence of anti-tumour necrosis factor therapy on cardiovascular risk factors in
patients with active rheumatoid arthritis.
Ann Rheum Dis.
2005;
64
303-305
MissingFormLabel
- 53
Popa C, Hoogen F H, Radstake T R. et al .
Modulation of lipoprotein plasma concentrations during long-term anti-TNF therapy
in patients with active rheumatoid arthritis.
Ann Rheum Dis.
Published Online First: 1 May 2007;
, http://ard.bmj.com/cgi/content/abstract/ard.2006.066191v1
MissingFormLabel
- 54
Adam van der O, Beringer C, Kless T. et al .
Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients
with rheumatoid arthritis.
Rheumatol Int.
2003;
23
27-36
MissingFormLabel
- 55
Keysser G.
Klinische Studien entzündlich-rheumatischer Erkrankungen in der Ernährungsmedizin.
Akt Rheumatol.
2007;
32
194-199
MissingFormLabel
- 56
Sundström B, Stålnacke K, Hagfors L. et al .
Supplementation of omega-3 fatty acids in patients with ankylosing spondylitis.
Scandinavian Journal of Rheumatology.
2006;
35
359-362
MissingFormLabel
- 57
Cleland L G, Caughey G E, James M J. et al .
Reduction of cardiovascular risk factors with longterm fish oil treatment in early
rheumatoid arthritis.
J Rheumatol.
2006;
33
1973-1979
MissingFormLabel
- 58
GISSI-Prevenzione Investigators .
Dietary suplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial
infarction: results of the GISSI-Prevenzione trial.
Lancet.
1999;
354
447-455
MissingFormLabel
- 59
Pham T, Gossec L, Constantin A. et al .
Cardiovascular risk and rheumatoid arthritis: clinical practice guidelines based on
published evidence and expert opinion.
Joint Bone Spine.
2006;
73
379-387
MissingFormLabel
- 60
Chung C P, Oeser A, Avalos I. et al .
Utility of the Framingham risk score to predict the presence of coronary atherosclerosis
in patients with rheumatoid arthritis.
Arthritis Res Ther.
2006;
8
R186
MissingFormLabel
- 61
Wilson P WF, D’Agostino R B, Levy D. et al .
Prediction of coronary heart disease using risk factor categories.
Circulation.
1998;
97
1837-1847
MissingFormLabel
1 Der Framingham-Score [60] ermöglicht auch bei Patienten mit einer rheumatoiden Arthritis eine Abschätzung des kardiovaskulären Risikos [61]. Eine Anleitung für die Kalkulation steht online zur Verfügung [62].
Priv. Doz. Dr. med. Hans-Eckhard Langer
Schwerpunkt für Rheumatologie, klinische Immunologie und Osteologie am Evangelischen
Krankenhaus Düsseldorf
Fürstenwall 99
40217 Düsseldorf
Phone: ++49/2 11/5 20 66 60
Fax: ++49/2 11/9 94 44 80
Email: dr.langer@rheuma-online.de