Heart Problems and Axial Spondyloarthritis

There are various conditions or diseases that occur at the same time as conditions on the AxSpA spectrum. These are called comorbid conditions. Some of these are more common than others, and early diagnosis of these disorders can help you get prompt treatment and improve symptoms and quality of life.

The risk of cardiovascular disease (CVD) is increased in people living with conditions on the AxSpA spectrum.¹ Knowing what the risk factors can be and which ones may be modifiable can help you make decisions to promote wellness and stay as healthy as possible.

What is cardiovascular disease (CVD)?

Cardiovascular disease (CVD) is an umbrella term for a group of disorders that affect the heart and blood vessels.² Worldwide, CVD is the leading cause of death, and more people die each year from CVD than any other disease.² CVD can include coronary heart disease, congenital heart disease, deep vein thrombosis or pulmonary embolism (blood clots in the heart or lungs), and rheumatic heart disease.² In 2016, 85 percent of deaths from CVD were from heart attack or stroke.²

In people living with a condition on the AxSpA spectrum, CVD has been found to be the leading cause of death.¹ CVD accounts for 30 to 50 percent of deaths in those with AxSpA spectrum conditions.¹ This is because there is more CVD present in those living with AxSpA spectrum conditions, and also because people with an AxSpA spectrum condition have more CVD risk factors than the general population.¹ This is why knowing the risk factors is important; you can try to reduce your risk by modifying some of these factors.

Why does CVD occur?

While some instances of CVD are not modifiable, like in congenital heart disease, when you are born with a heart condition, there are risk factors for CVD that can increase one’s risk for developing CVD. Some of these are modifiable, which means they can be changed. Making healthy changes may help to reduce your risk of developing CVD.

There are 5 main modifiable CVD risk factors:¹

1. Hypertension (high blood pressure)
2. Smoking cigarettes
3. Dyslipidemia (abnormal amount of fats in the blood like cholesterol and triglycerides)
4. Diabetes
5. Obesity

In people with AxSpA spectrum conditions, some of these like hypertension, can be related to chronic systemic inflammation.¹ It can also be hard to maintain an active lifestyle, which can help reduce blood pressure and obesity, when you have the pain and stiffness associated with AxSpA conditions.

Other risk factors include a sedentary lifestyle and drinking large amounts of alcohol.

Quitting smoking, trying to stay active with regular physical activity if possible, reducing saturated fats and salt in the diet, reducing alcohol consumption, and sticking to a diabetes treatment plan can all help reduce your risk of CVD.

How is CVD diagnosed and treated?

Diagnosis of CVD is done by a variety of tests. The tests that are done depend on what kind of heart disease your doctor thinks you might have.⁴ Blood tests may be done, along with tests like a stress test, heart monitoring over 24 to 72 hours, electrocardiogram (ECG), cardiac magnetic resonance imaging (MRI), a cardiac computerized tomography scan (CT scan) or a cardiac catheterization. A catheterization is where a tube is inserted into a vein or artery until it reaches your heart, so dye can be inserted into the tube for visualizing the heart on an X-ray.⁴

Treatment for CVD depends on the specific condition. Treatment generally includes lifestyle changes or modifications, medications, and medical procedures or surgery. Treatment may change over time if your condition progresses or if a treatment stops being effective.