Cardiovascular Risk Assessment in Rheumatic Diseases
Özet
Rheumatologic diseases are chronic conditions in which the immune system causes damage to joints, muscles, and organs through autoimmune or inflammatory mechanisms. It is well known that inflammatory forms of these diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and psoriatic arthritis (PsA), increase the risk of cardiovascular (CV) diseases. Inflammation accelerates the development of atherosclerosis, thereby increasing the risk of myocardial infarction, stroke, and other CV events.
Traditional CV risk factors (hypertension, diabetes, hyperlipidemia, smoking, obesity) are more prevalent in patients with rheumatologic diseases and become more complex due to disease activity. Additionally, chronic inflammation, corticosteroids, and immunosuppressive treatments further contribute to increased CV risk. Therefore, early diagnosis, regular CV risk assessment, and multidisciplinary management are crucial for individuals with rheumatologic diseases.
Since conventional risk scoring systems (SCORE, Framingham) may be misleading in these patients, specific models incorporating rheumatologic conditions are recommended. Lifestyle modifications, appropriate pharmacological treatment, and inflammation control are key strategies in preventing CV diseases in these patients.
Romatolojik hastalıklar, bağışıklık sisteminin otoimmün veya inflamatuvar mekanizmalarla eklem, kas ve organlara zarar verdiği kronik hastalıklardır. Bu hastalıkların, özellikle romatoid artrit (RA), sistemik lupus eritematozus (SLE), ankilozan spondilit (AS) ve psöriyatik artrit (PsA) gibi inflamatuvar formlarının, kardiyovasküler (KV) hastalık riskini artırdığı bilinmektedir. İnflamasyon, ateroskleroz gelişimini hızlandırarak miyokard enfarktüsü, inme ve diğer KV olayların riskini artırabilir.
Romatolojik hastalıklarda geleneksel KV risk faktörleri (hipertansiyon, diyabet, hiperlipidemi, sigara kullanımı, obezite) daha sık görülmekte ve hastalığın aktivitesine bağlı olarak daha karmaşık bir hale gelebilmektedir. Ayrıca, kronik inflamasyon ve kullanılan kortikosteroidler, immünsüpresif tedaviler gibi ilaçlar da KV riskini artırabilir. Bu nedenle, romatolojik hastalığı olan bireylerde erken tanı, düzenli KV risk değerlendirmesi ve multidisipliner yönetim büyük önem taşımaktadır.
Risk değerlendirmesi için geleneksel skorlama sistemleri (SCORE, Framingham) yanıltıcı olabileceğinden, romatolojik hastalıkları içeren özel modellerin kullanılması önerilmektedir. Yaşam tarzı değişiklikleri, uygun farmakolojik tedavi ve inflamasyonun kontrol altına alınması, KV hastalıkların önlenmesinde temel stratejilerdir.
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