The increased risk of cardiovascular disease (CVD) among patients with autoimmune rheumatic
diseases such as rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus has
been extensively documented. Sub-clinical atherosclerosis can be assessed using various non-invasive
imaging techniques. However, the mechanisms underlying the higher risk of atherosclerotic CVD in
patients with autoimmune rheumatic diseases are not fully known, although they seem to include
chronic low-grade systemic inflammation leading to prolonged endothelial activation, accompanied by a
pro-thrombotic/pro-coagulant and autoantibody state. Furthermore, sub-clinical atherosclerosis is also
influenced by other traditional risk factors for CVD. Including the individual components of the metabolic
syndrome (MetS: obesity, impaired glucose metabolism, dyslipidemia and high blood pressure),
the degree of which is higher in these patients than in controls. The aim of this narrative review is to
discuss the CV manifestations and risk factors involved in the increased risk of CVD among patients
with autoimmune rheumatic diseases.
Keywords: Cardiovascular involvement, systemic lupus erythematosus, rheumatoid arthritis, spondyloarthritis, CVD, atherosclerosis.
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