Arthritis: its prevalence, risk factors, and association with cardiovascular diseases in the United States National Health and Nutrition Examination Survey 1999-2008

Abstract

INTRODUCTION: Arthritis is associated with cardiovascular diseases (CVDs). However, there are limited studies on arthritis in a national representative sample. We therefore investigated the prevalence of arthritis, and whether cardiovascular risk factors were associated with arthritis. METHODS: Data from 15,888 subjects aged ≥40 years in the United States National Health and Nutrition Examination Survey 1999-2008 were analyzed. RESULTS: The overall prevalence of self-reported arthritis increased from 33.5% in 1999-2000 to 37.0% in 2007-2008 (P for trend=0.016). Among subjects with arthritis in 1999-2008, 35.3% had osteoarthritis (OA), 17.9% had rheumatoid arthritis (RA), and 10.2% had other types of arthritis, but 36.6% were unaware of their type of arthritis. Risk factors such as age, gender, BMI, smoking, hypertension, education, alcohol drinking, total cholesterol, CRP, and biomarkers of liver injury were associated with OA, RA, or both. OA was associated with CVDs (adjusted OR=1.57, P<0.001) and showed interaction with total cholesterol (P=0.032) with adjusted Ors for CVDs being 1.09, 1.37, 2.07, and 2.50 in subjects with total cholesterol in sex-specific quartiles 1, 2, 3, and 4 respectively. RA was associated CVDs (adjusted OR=2.39, P<0.001) and showed interaction with HDL cholesterol (P=0.012) with adjusted ORs for CVDs being 2.06, 2.42, 2.28, and 3.12 in subjects with HDL cholesterol in sex-specific quartiles 1, 2, 3, and 4 respectively.