AB1257 CARDIOVASCULAR RISK FACTORS IN GOUT COMPARED TO AS, PSA AND RA – RESULTS FROM A QUESTIONNAIRE STUDY

Abstract

Background: Increased risk for cardiovascular disease (CVD) is a hallmark for many rheumatic diseases including gout, ankylosing spondylitis (AS), psoriatic arthritis (PsA) and rheumatoid arthritis (RA). This is likely explained by a combination of increased occurrence of CVD risk factors (CVDRF) and chronic inflammation and in gout possibly by increased serum urate levels. Objectives: To compare the prevalence of CVRFs and CVD in gout, AS, PsA and RA. Methods: All individuals aged ≥18 years with at least one ICD‐10 diagnosis of gout (M10), AS (M459), PsA (M073) and RA (M059/M060) recorded by a physician during a two year period (Jan 2015 through Feb 2017) were identified at 12 primary care centers and three rheumatology units in the Western Sweden Health Care Region. A total of 1589 gout, 1095 AS, 1200 PsA and 1246 RA subjects were sent a questionnaire which included questions on demographics, CVRFs (smoking, alcohol consumption, physical activity (PA)) and comorbidities (diabetes (DM), hypertension (HT), dyslipidemia (DL), acute coronary syndrome (ACS) and stroke). High alcohol intake was defined as >4 std drinks/week. Low PA was defined as ≤3 hours of moderate PA/week. Primary non‐responders received a second mailing of the questionnaire. All prevalences were indirectly age standardized (IAS) to the population of Sweden 2017, due to the differences in age distribution between the diseases. Chi square test with significance level .05 was performed. IAS prevalences for BMI, PA, DM and HT for the general population (GP) was retrieved from the National public health survey from 2015 which was sent to more than 100 000 randomly selected citizens in Sweden aged 16‐84. Results: Response rates ranged from 53.6% (AS) to 59.6% (RA) and after excluding subjects who had not provided complete information on the evaluated variables we included 2437 individuals. The gout and RA patients were older (mean age 71 (SD 12) and 66 (SD 13) years respectively) compared to AS and PsA (mean age 50 (SD 14) and 55 (SD 13) years respectively). When adjusting for these differences by IAS by sex, both prevalent CVD (stroke, ACS) and all traditional risk factors were more common in gout compared to RA, AS or PsA (Table 1+2), except for alcohol intake in women, where highest exposure was seen in PsA (Table 2). The male AS patients displayed the highest PA level and the lowest prevalence of stroke (table 1). Smoking was least common in male PsA and female AS and RA patients (table 1+2). Age‐standardized prevalences of CVD riskfactors and outcomes in females, ∗Chi‐square comparing gout, AS, PsA and RA Conclusion: Gout patients display the highest prevalence of CVRFs in both men and women compared to AS, PsA and RA. Thus, addressing CVDRFs is of particular importance in patients with gout. (Table Presented) .