TY - JOUR
T1 - Common mechanisms and holistic care in atherosclerosis and osteoporosis 11 Medical and Health Sciences 1103 Clinical Sciences
AU - Szekanecz, Zoltán
AU - Raterman, Hennie G.
AU - Petho, Zsófia
AU - Lems, Willem F.
PY - 2019
Y1 - 2019
N2 - Cardiovascular (CV) disease and osteoporosis (OP) have become increasing challenges in the aging population and even more in patients with inflammatory rheumatic diseases, such as rheumatoid arthritis, spondyloarthropathies, and systemic lupus erythematosus. In this review, we discuss how the epidemiology and pathogenesis of CV events and OP are overlapping. Smoking, diabetes mellitus, physical inactivity as conventional risk factors as well as systemic inflammation are among the modifiable risk factors for both CV events and bone loss. In rheumatic patients, systemic "high-grade" inflammation may be the primary driver of accelerated atherogenesis and bone resorption. In the general population, in which some individuals might have low-grade systemic inflammation, a holistic approach to drug treatment and lifestyle modifications may have beneficial effects on the bone as well as the vasculature. In rheumatic patients with accelerated inflammatory atherosclerosis and bone loss, the rapid and effective suppression of inflammation in a treat-to-target regime, aiming at clinical remission, is necessary to effectively control comorbidities.
AB - Cardiovascular (CV) disease and osteoporosis (OP) have become increasing challenges in the aging population and even more in patients with inflammatory rheumatic diseases, such as rheumatoid arthritis, spondyloarthropathies, and systemic lupus erythematosus. In this review, we discuss how the epidemiology and pathogenesis of CV events and OP are overlapping. Smoking, diabetes mellitus, physical inactivity as conventional risk factors as well as systemic inflammation are among the modifiable risk factors for both CV events and bone loss. In rheumatic patients, systemic "high-grade" inflammation may be the primary driver of accelerated atherogenesis and bone resorption. In the general population, in which some individuals might have low-grade systemic inflammation, a holistic approach to drug treatment and lifestyle modifications may have beneficial effects on the bone as well as the vasculature. In rheumatic patients with accelerated inflammatory atherosclerosis and bone loss, the rapid and effective suppression of inflammation in a treat-to-target regime, aiming at clinical remission, is necessary to effectively control comorbidities.
KW - Atherosclerosis
KW - Bone loss
KW - DXA
KW - Inflammation
KW - Osteoporosis
KW - Rheumatoid arthritis
KW - Risk factors
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059801605&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30630495
U2 - https://doi.org/10.1186/s13075-018-1805-7
DO - https://doi.org/10.1186/s13075-018-1805-7
M3 - Review article
C2 - 30630495
SN - 1478-6354
VL - 21
JO - Arthritis Research and Therapy
JF - Arthritis Research and Therapy
IS - 1
M1 - 15
ER -