Monitoring and Managing Cardiovascular Risk in Immune Mediated Inflammatory Diseases

Figures

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  Figure 1. Factors implicated in the pathogenesis of increased cardiovascular disease (CVD) risk in patients with immune-mediated inflammatory diseases. Traditional CVD risk factors, disease-related factors triggered by the dysregulation of innate immunity, and the current and cumulative inflammatory burden, act synergistically and promote the pathophysiological processes of endothelial dysfunction, arterial stiffness and oxidative stress. The mutual interplay of these factors eventually leads to accelerated atherosclerosis, subclinical micro- and macrovascular damage and subsequently, clinically evident CVD.

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  Figure 2. The three pillars of cardiovascular disease (CVD) risk management in patients with IMIDs: 1) effective control of inflammation, 2) lifestyle modifications targeting at modifiable CVD risk factors, and 3) simultaneous control of cardiovascular comorbidities. Positive interactions between these interventions are expected not only towards modulation of CVD risk, but also towards substantial improvement of patients’ general health and well-being. At the same time, individual CVD risk needs to be determined and regularly reassessed according to the presence of cardiovascular comorbidities, the current and cumulative inflammatory load, and the cardiovascular effects of antirheumatic medication.