Cardiovascular Risk Burden in Sub-Saharan Africans with Rheumatoid Arthritis: A Hospital-Based Study in Yaounde, Cameroon

Introduction: Studies on RA (rheumatoid arthritis) and cardiovascular risk in African countries are scarce. Objective: To investigate the relationship between RA and cardiovascular risk in Cameroonian patients. Methodology: In 50 Black RA patients and 51 matched healthy individuals from the general population, we studied cardiovascular risk factors validated by the WHO. Cardiovascular risks estimates were carried out using WHO risk charts for the African region. Epi-info, R and SPPS were used for the statistical analysis. Results: Overall and abdominal adiposity as expressed by increased body mass index and abdominal obesity, were all markedly increased in RA patients compared to non-RA subjects [70% vs. 47%, OR (95% CI) = 2.62 (1.16 - 5.94), p = 0.026; and 54% vs. 33%, OR (95% CI) = 2.34 (1.05 - 5.25), p = 0.045 respectively]. RA patients were more physically inactive than their non-RA counterparts (20% vs. 0, p = 0.001). Whereas RA was associated with a reduced odds of alcoholism [OR (95% CI) = 0.19 (0.06 - 0.62), p = 0.005]. Increased BMI seemed to occur independently of methotrexate (p = 0.76), hydroxychloroquine (p = 0.59), corticosteroids (p = 0.79) treatments, and independently of sex (p = 0.15), age (p = 0.67), and sedentary lifestyle (p = 0.16) in RA patients; but their BMI was weakly correlated with disease duration (r = 0.26; p = 0.074). Meanwhile, male gender was associated with a reduced odds of abdominal obesity [OR (95% CI) = 0.02 (0 - 0.4), p = 0.011]. Cardiovascular risk, comparable by proportions between RA and non-RA subjects, was low in 26 patients (78.8%) and 30 non-RA subjects (83.3%) respectively. Conclusion: Despite the high adiposity burden and a sedentary lifestyle experienced by RA patients compared to their healthy counterparts, RA was not associated with cardiovascular risk as estimated by WHO risk charts.