LAUSR

Background: Only a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. Methods: Data regarding 52,840 subjects (10,568 patients with RA and 42,272 age‐, sex‐, urbanization‐, and income‐matched non‐RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. Results: RA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95% confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35‐fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95% CI, 7.22–11.41) relative to subjects without RA and hypertension. Conclusion: RA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.