Autoimmune diseases can be dangerous for the heart.

Improving cardiac treatment for patients with autoimmune illnesses is the goal of the expanding discipline of cardio-rheumatology.

Your body is protected from bacteria, viruses, and other invaders by the network of specialized cells and organs that make up your immune system. However, occasionally immune cells target the body's own tissues inappropriately for reasons that are still mostly unknown. White blood cells and other chemicals are released as a result, which leads to inflammation and the pain, swelling, and redness that define many autoimmune diseases. However, inflammation also degrades the blood vessel linings, promoting the accumulation of fatty plaque that can cause atherosclerosis, restrict the arteries, increase blood pressure, and increase the risk of a heart attack or stroke. This relationship probably explains why heart disease rates are higher in those with autoimmune diseases like rheumatoid arthritis. But up until recently, it was unknown how serious and widespread this issue was.

Autoimmune diseases: From prevalent to uncommon

Up to 8% of Americans experience an autoimmune illness, which results from the immune system unintentionally attacking healthy tissues or organs. Women are twice as likely as men to acquire these disorders, for reasons that are unknown. The three autoimmune diseases listed here are among the most prevalent and well-researched of the more than 100 identified autoimmune diseases. However, most of them are uncommon, making them less well known.

Psoriasis causes skin inflammation that results in a scaly, pink, or dull-red skin rash that appears in spots, mainly on the scalp, in skin folds, and on the back of the elbow. Psoriatic arthritis, which causes morning stiffness and joint inflammation, particularly in the fingers, toes, or knees, affects around one in three people with psoriasis.

Rheumatoid arthritis. The tissue lining the joints is attacked by the immune system, resulting in inflammation that is characterized by pain, swelling, and stiffness. Usually, it affects several joints at once, particularly the hands and feet. Exhaustion and persistent stiffness in the morning are other symptoms.

Lupus. The inflammatory process that causes lupus can have an impact on almost every organ in the body, resulting in a wide range of symptoms. Fever and rheumatoid arthritis-like joint discomfort are typical early symptoms. A "butterfly rash" that runs over the cheekbones and nasal bridge is one noticeable sign. Additionally, harm to the kidneys, lungs, heart, and blood vessels may occur.

An increased risk

However, research that examined the incidence of cardiovascular disease in conjunction with 19 of the most prevalent autoimmune diseases was published in the Lancet in 2022. People with these autoimmune disorders were up to three times more likely than those without them to develop cardiovascular disease, depending on the exact ailment.

Numerous patients under her care have lupus, psoriatic arthritis, or rheumatoid arthritis—three frequent diseases associated with cardiovascular issues.

Since autoimmune diseases usually affect people in their 20s or 30s, it is especially crucial to be aware of this increased risk. Consequently, cardiac issues might manifest up to ten years before they do in those without an inflammatory illness. A calcium scan helps determine an individual's risk and provide treatment recommendations by identifying early indicators of atherosclerosis. Sometimes symptoms (such as dyspnea while ascending stairs) that are really caused by heart disease are misdiagnosed as rheumatoid arthritis.

Advice on treatment

Cardio-rheumatologists collaborate with rheumatologists to supervise the proper use of disease-modifying biologic therapies, some of which have a higher risk of cardiovascular adverse effects than others. They also prescribe statins and other treatments that reduce the risk of heart attacks.

People with autoimmune diseases benefit from the same diets that are advised for reducing heart disease. Sustaining a healthy weight is also beneficial. Many patients like swimming, which is easy on the joints. People with autoimmune diseases, especially those with severe cases of rheumatoid arthritis, may have limited mobility, making exercise particularly challenging."

Others find yoga beneficial, particularly for the additional stress reduction and relaxation it offers. Another activity that might increase heart rate without overstressing the joints is using an elliptical machine.

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