Physical activity reduces cardiovascular risk in patients with rheumatism

People with diseases such as rheumatoid arthritis and lupus are more likely to have a heart attack, angina, or stroke. A review of the scientific literature on this subject shows that regular exercise improves vascular function in these patients (Photo: Diego Rezende).

People with autoimmune rheumatic diseases are at greater risk of developing atherosclerosis (the arteries narrow and blood flow is blocked as cholesterol plaque builds up). As a result, you are more likely to have a heart attack or other cardiovascular accident.

Good news, according to a new study published in Rheumatoid arthritisRegular exercise is a powerful weapon against vascular dysfunction in these patients.

In this article, researchers working in Brazil and the United Kingdom report the results of a systematic review of the scientific literature on this subject. This FAPESP-backed review featured 10 studies of 355 volunteers with a variety of disorders, including rheumatoid arthritis, lupus, and spondyloarthritis (inflammation of the spine). Subjects attended exercise programs such as walking in parks and treadmills, exercise bikes, high-intensity interval training, and muscle building. Most programs lasted 12 weeks.

“Analysis of the results showed that exercise improved small vessel endothelial function and macrovascular endothelial function to a clinically significant extent, as it may reduce the incidence of cardiovascular events. It was suggested that exercise could be considered a “medication” for these patients. “The first author of the article, Tiago Pecanha, said. Peçanha is a postdoctoral fellow at the University of Sao Paulo School of Medicine (FM-USP) in Brazil.

He explained that these rheumatic diseases are the result of an imbalance in the immune system, leading to the production of antibodies to the subject’s own organisms, especially joints, muscles, ligaments and tendons. There is no definitive cure for these diseases, but they can be controlled by treatment with anti-inflammatory drugs, immunosuppressants, and biologics (biological drugs).

“Treatment does not prevent patients from developing certain comorbidities. Cardiovascular disease is of most concern,” Peçanha said. “People with rheumatoid arthritis are twice as likely to have a heart attack as healthy people. People with lupus or psoriatic arthritis are 2 to 5 times more likely to have an ischemic event (heart attack, angina, stroke). is. “”

In these patients, chronic inflammation associated with rheumatoid arthritis and continued use of anti-inflammatory drugs lead to rapid onset of atherosclerosis. “It all starts with changes in the structure and function of blood vessels,” Peçanha said. “Arteries gradually harden and cannot dilate as needed. In particular, changes occur in the endothelium (the layer of cells that line the inner surface of blood vessels). Changes in vascular function, especially endothelial function, are atherosclerosis. It is considered the first marker of illness. For this reason. “

Systematic reviews have shown that exercise improves vascular function in small and large vessels in patients with autoimmune rheumatoid disease. However, the authors state that given the small number of studies reviewed, there is insufficient evidence to articulate that exercise also promotes structural recovery of damaged arteries.

“Because this area (physical activity in rheumatology) is still new, more research is needed to identify the best exercise protocols and investigate aspects such as safety and compliance,” said Peçanha. “In any case, the data in our study underscore the importance of regular exercise to prevent and treat cardiovascular disease in these patients.”

For people with rheumatoid arthritis, like everyone else, Peçanha recommends moderate to strenuous exercise for at least 150 minutes a week. Aerobic exercise is predominant and should be complemented by activities that promote strength and balance.

“I’m at home, but I’m still,” the researchers recommend.

For more information:
Tiago Peçanha et al., Effects of Physical Activity on Vascular Function in Autoimmune Rheumatoid Arthritis: Systematic Review and Meta-Analysis, Rheumatoid arthritis (2021). DOI: 10.1093 / rheumatology / keab094

Quote: Physical activity of patients with rheumatism (April 27, 2021) obtained from on April 27, 2021. Reduces cardiovascular risk

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Physical activity reduces cardiovascular risk in patients with rheumatism

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