Ankylosing Spondylitis Carries Vascular Risk

Researchers associate ankylosing spondylitis (AS), a chronic inflammatory arthritis that affects the spine of young people, mostly young men, with an increased risk of vascular mortality. Reporting in the Annals of Internal Medicine in August, lead author Nisha Nigil Haroon, MD, DM, DNB, MSc, Ontario School of Medicine, Canada, compared 21,473 patients with AS, aged 15 years and older, to 86, 606 without the disease to draw a composite of AS cardiovascular and cerebrovascular mortality. The study “Patients with Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality: A Population-Based Study Increased Cardiovascular and Cerebrovascular Mortality in Ankylosing Spondylitis” calls for a comprehensive strategy to screen and treat modifiable vascular risk factors.

Matched for age, sex, and residence location, the population-based retrospective cohort study used administrative health data to calculate vascular death based on hazard ratios (HRs), adjusted for history of cancer, diabetes, dementia, inflammatory bowel disease, hypertension, chronic kidney disease, and peripheral vascular disease and, among those aged 66 years or older, relevant drug therapies. Independent risk factors for vascular mortality also factored in the equation.

Haroon and her team determined a mean AS patient age of 46 with higher adjusted HRs for vascular death among men (1.36) than women (1.24). “Significant risk factors” related to age, male gender, lower income, dementia, chronic kidney disease and peripheral vascular disease. Among patients, over age 65, “lack of exposure to nonsteroidal, anti-inflammatory drugs and statins, contributed to death.