October 13, 2015Open Access
View Full PaperAssociation between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis
Key Result
Osteoarthritis was associated with an increased risk of heart failure (RR 2.80; 95% CI 2.25-3.49) and ischaemic heart disease (RR 1.78; 95% CI 1.18-2.69) compared to non-osteoarthritis cohorts.
Study Design
Type
Meta-Analysis (n=32,278,744)
Structured PICO
Is osteoarthritis associated with an increased risk of cardiovascular disease compared with non-osteoarthritis cohorts?
P
Population
32,278,744 individuals from 15 studies (cohort, case-control, randomised and non-randomised controlled trials)
I
Intervention
Osteoarthritis (exposure)
C
Comparator
Matched non-osteoarthritis cohorts
O
Outcome
Prevalence of cardiovascular disease pathologyhard clinical
Osteoarthritis is associated with a significantly increased prevalence of cardiovascular disease, particularly heart failure and ischaemic heart disease, highlighting the need to understand shared pathophysiological mechanisms.
Main Result
Effect estimate: RR 2.80 (95% CI 2.25 to 3.49)
Abstract
BACKGROUND: To examine for a possible relationship between osteoarthritis and cardiovascular disease. DESIGN: A systematic review and meta-analysis. METHODS: Published and unpublished literature from: MEDLINE, EMBASE, CINAHL, the Cochrane Library, OpenGrey and clinical trial registers. Search to 22 November 2014. Cohort, case-control, randomised and non-randomised controlled trial papers reporting the prevalence of cardiovascular disease in osteoarthritis were included. RESULTS: Fifteen studies with 32,278,744 individuals were eligible. Pooled prevalence for overall cardiovascular disease pathology in people with osteoarthritis was 38.4% (95% confidence interval (CI): 37.2% to 39.6%). Individuals with osteoarthritis were almost three times as likely to have heart failure (relative risk (RR): 2.80; 95% CI: 2.25 to 3.49) or ischaemic heart disease (RR: 1.78; 95% CI: 1.18 to 2.69) compared with matched non-osteoarthritis cohorts. No significant difference was detected between the two groups for the risk of experiencing myocardial infarction or stroke. There was a three-fold decrease in the risk of experiencing a transient ischaemic attack in the osteoarthritis cohort compared with the non-osteoarthritis group. CONCLUSIONS: Prevalence of cardiovascular disease in patients with osteoarthritis is significant. There was an observed increased risk of incident heart failure and ischaemic heart disease in people with osteoarthritis compared with matched controls. However, the relationship between osteoarthritis and cardiovascular disease is not straightforward and there is a need to better understand the potential common pathways linking pathophysiological mechanisms.