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Abstract
Objective: To investigate the hypothesis that cardiovascular risk factors increase the likelihood of future osteoarthritis (OA)-related arthroplasty in adult men and women.
Methods: Baseline cohort data on cardiovascular risk factors [age, socio-economic class, family history, obesity, smoking, glucose, cholesterol, blood pressure, and early cardiovascular disease (CVD) history] were linked to clinical registers of OA-related arthroplasty data. The study included 8749 women and 14 821 men with up to a 30-year follow-up.
Results: In women, higher cardiovascular risk groups were more likely to have an OA outcome compared to the lowest risk quartile group (trend p < 0.001). The estimates were as follows: second quartile risk: rate ratio (RR) 2.15, 95% confidence interval (CI) 1.6–2.9, third quartile risk: 3.32 (2.5–4.5); and highest risk quartile: 3.47 (2.6–4.7). In men, higher cardiovascular risk groups were also more likely to have an OA outcome compared to the lowest risk quartile group (trend p = 0.001). The estimates were as follows: second quartile risk: RR 1.44, 95% CI 1.1–1.9; third quartile risk: 1.38 (1.1–1.8); and highest risk quartile: 1.67 (1.3–2.2).
Conclusions: Our large cohort study with up to a 30-year follow-up period provides evidence to support the hypothesis of shared risk factors in CVD and OA, and the findings suggest an alternative aetiological process in the pathogenesis of OA.
Acknowledgements
We thank the participants and original investigators of the MPP cohort study. UTK was funded by a National Institute for Health Research (NIHR) Post-Doctoral Fellowship (grant no. PAS/PDA/03/07/035) and by a Royal Society International Short Visit grant and the West Midlands Advantage scheme. We thank Dr Martyn Lewis and Peter Croft for their advice. This study was also supported by grants from the Swedish Research Council, Malmö University Hospital Research Foundations, and the Medical Faculty of Lund University.