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Review
. 2016 May 20;5(5):e84.
doi: 10.1038/cti.2016.31. eCollection 2016 May.

Is the risk of cardiovascular disease altered with anti-inflammatory therapies? Insights from rheumatoid arthritis

Michael J Kraakman  1 , Dragana Dragoljevic  2 , Helene L Kammoun  2 , Andrew J Murphy  2
Affiliations
Review

Is the risk of cardiovascular disease altered with anti-inflammatory therapies? Insights from rheumatoid arthritis

Michael J Kraakman et al. Clin Transl Immunology. .

Abstract

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Atherosclerosis is the most common form of CVD, which is complex and multifactorial with an elevated risk observed in people with either metabolic or inflammatory diseases. Accumulating evidence now links obesity with a state of chronic low-grade inflammation and has renewed our understanding of this condition and its associated comorbidities. An emerging theme linking disease states with atherosclerosis is the increased production of myeloid cells, which can initiate and exacerbate atherogenesis. Although anti-inflammatory drug treatments exist and have been successfully used to treat inflammatory conditions such as rheumatoid arthritis (RA), a commonly observed side effect is dyslipidemia, inadvertently, a major risk factor for the development of atherosclerosis. The mechanisms leading to dyslipidemia associated with anti-inflammatory drug use and whether CVD risk is actually increased by this dyslipidemia are of great therapeutic importance and currently remain poorly understood. Here we review recent data providing links between inflammation, hematopoiesis, dyslipidemia and CVD risk in the context of anti-inflammatory drug use.

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Figures

Figure 1
Figure 1
Is cardiometabolic risk elevated with anti-inflammatory drug use? (a) Metabolic disorders such as obesity, hyperglycemia and dyslipidemia increase the risk of cardiovascular disease. (b) Inflammatory diseases are hallmarked by enhanced myelopoiesis and increased cytokine levels that can directly elevate cardiovascular risk. (c) Metabolic dysfunction and inflammation can also be interconnected to further drive cardiovascular risk. (d) Anti-inflammatory treatments reduce disease severity and dampen inflammation, which appears to lower cardiovascular risk. (e) However, anti-inflammatories are also associated with elevated lipid levels and could potentially have a negative impact on cardiovascular risk over time.
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