People who have rheumatoid arthritis (RA) should take a low-dose aspirin once a day I because they are more likely to develop heart disease. But new research suggests that many patients aren't getting this message, potentially putting them at risk.

Researchers found that just 18% of RA patients are using aspirin therapy, widely considered an effective and inexpensive way to prevent heart attacks. Meanwhile, a similar group of people who have other types of arthritis are significantly more likely to take aspirin every day-in fact, 25% of them do, the study found.

The Study

The researchers surveyed 18,723 arthritis patients for three years. The majority-14,114- had the rheumatoid form.

Of the RA patients, only 18.4% took an aspirin every day to prevent heart disease, compared with 25.1% of the patients who had other forms of arthritis.

For reasons that are not entirely clear, people who have RA are twice as likely to develop heart disease, says study coauthor Dr. Lee Colglazier, a rheumatologist in Crestview Hills, Kentucky, who worked on the study as a rheumatology fellow at 'Wake Forest University School of Medicine in Winston-Sa1em, North Carolina. Some theories suggest that the inflammation triggered by RA contributes to cholesterol buildup and artery blockages.

Searching For An Explanation

The reason for overlooking aspirin therapy is not clear, but it may have something to do with rheumatologists and primary-care doctors failing to consider a patient's overall health, says Dr. Eric Ruderman, an associate professor of medicine at Northwestern University's Feinberg School of Medicine. "Maybe we're not looking at the rest of the picture as much as we should," he says.

The findings are mystifying, especially because RA patients are hardly strangers at doctors' offices, Colglazier says. "Maybe they're seeing the doctor a lot, [and] a lot of acute things are going on, [so] doctors don't have time to say, 'Let's address prevention."'

Ruderman agrees, adding that primary-care doctors might not realize the heart-risk urgency facing RA patients.

Perhaps "they don't view these patients with the same concern that they may view a diabetic or a patient who has significant hypertension or elevated cholesterol," he says.

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