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GPs urged to tackle CV risk factors in patients with polymyalgia rheumatica

Patients with polymyalgia rheumatica are at an increased risk of cardiovascular events, suggests a recent UK study.

The study identified 3249 patients with a diagnosis of incident polymyalgia rheumatica over a 12-year period from the General Practice Research Database. Patients were matched by age, sex and practice, with one patient with polymyalgia rheumatica being paired with up to five patients without the condition, resulting in 12,735 matched patients. All participants were aged 50 years or older, and were followed until their first vascular event – cardiovascular, cerebrovascular or peripheral vascular – or until the end of the available records. All participants were free of vascular disease before the diagnosis of polymyalgia rheumatic or matched date.

Over a median follow-up period of 7.8 years, the rate of vascular events was three times higher among patients with polymyalgia rheumatica than among those without, with 36.1 events per 1000 patient years occurring in patients with polymyalgia rheumatic and 12.2 in those without the condition. The increased risk of vascular events was similar for each vascular disease end-point – patients with polymyalgia rheumatica had a more than two-fold increase in the risk of experiencing a cardiovascular, cerebrovascular or peripheral vascular event, compared to patients without polymyalgia rheumatica. Patients under the age of 60, with polymyalgia rheumatica, were five times more likely to experience any vascular event, compared to those of the same age without polymyalgia rheumatica. This fell to a two-fold increase in risk for patients aged 60-69, and patients aged 70-79, but remained significant compared to patients in the same age bracket without the condition.

The researchers advised that ‘aggressive management of vascular risk factors should be considered in patients with polymyalgia rheumatica to try to attenuate this excess risk’.

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