High prevalence of cardiovascular comorbidities in patients with rheumatoid arthritis from a population-based cross-sectional study of a Japanese health insurance database

Abstract

Objective: To reveal any association between rheumatoid arthritis (RA) and cardiovascular comorbidities using a Japanese health insurance database.

Method: This population-based cross-sectional study was conducted using health insurance data provided by the Japan Medical Data Center Co., Ltd. We identified 2762 RA subjects having RA diagnostic codes (ICD10 codes; M05, M060, M062–63, M068–069) with at least two physician visits more than two months apart between June 2011 and May 2012 (RA group, n = 2762). We selected age- (±5 years), sex-, and study period-matched non-RA subjects (non-RA group, n = 27,620). We compared the prevalence of cardiovascular and related comorbidities (ischemic heart diseases [IHD], cerebral infarction, hypertension [HT], dyslipidemia [DL], and diabetes mellitus [DM]) between these groups and investigated the association between RA and cardiovascular comorbidities using a conditional logistic regression analysis.

Results: The prevalence of all the investigated comorbidities in the RA group was significantly higher compared to the non-RA group. Odds ratios [95% confidence interval] of RA for IHD and cerebral infarction were 2.0 [1.5–2.5] and 3.1 [2.2–4.2] respectively, after adjusting for HT, DL, and DM.

Conclusions: This study revealed for the first time in the Japanese population that RA was significantly associated with cardiovascular comorbidities.

Keywords:

• Comorbidity
• Epidemiology
• Rheumatoid arthritis
• Prevalence

Acknowledgments

The authors sincerely thank Yoshinori Zushi (Stagen Co., Ltd.) for his contribution of the extraction procedures of JMDC claims data, Rie Nishikino (JMDC) for her useful advice, and Marie Yajima (Tokyo Medical and Dental University) for her help with acquisition of JMDC claims data.

Conflict of interests

MH received unrestricted research grants for Departments of Pharmacovigilance from Abbvie Japan Co., Ltd., Astellas Pharma Inc., Bristol Myers Squibb K.K., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Ono Pharmaceuticals, Pfizer Japan Inc., Sanofi-Aventis KK., Santen Pharmaceutical Co., Ltd., Sekisui Medical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Ltd., and UCB Japan with which TMDU pays salary for RS, HY, TN, and MH. NM has received research grants from Abbott Japan Co., Ltd., Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Dainihon-Sumitomo Pharma Co. Ltd., Daiichi-Sankyo Co. Ltd., Eisai Co. Ltd., Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Ltd., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Ltd and has received consulting fees or honoraria from Abbott Japan Co., Ltd., Bristol Myers Squibb, Janssen Pharmaceutical KK, and Otsuka Pharmaceutical Co. Ltd. FH, MK, WY, and RK have nothing to declare.

This work was supported by a grant-in-aid from the Ministry of Health, Labor and Welfare, Japan (H19-meneki-ippan-009 and H23-meneki-shitei-016 to N. Miyasaka, H22-meneki-ippann-001 and H23-meneki-shitei-016 to M. Harigai).