Inflammation plays a central role in rheumatoid arthritis. That inflammation, or swelling, is what leads to joint damage and serious pain. Inflammation also plays a role in certain blood clotting disorders. So could rheumatoid arthritis patients be at risk of clotting disorders?
A recent study found that rheumatoid arthritis is linked to a higher risk of developing vein issues. Those vein disorders could lead to deadly blood clots.
The researchers hoped that their findings would lead to better approaches in dealing with rheumatoid arthritis to prevent blood clots.
"Talk to your doctor about the risks of rheumatoid arthritis."
Wei-Sheng Chung of the Central Taiwan University of Science and Technology, along with several colleagues, conducted this study to examine the effects of arthritis on vein and circulation issues.
Rheumatoid arthritis is a disease in which tissues become irritated and inflamed. A person with rheumatoid arthritis often has stiff and tender joints. Also, some patients with rheumatoid arthritis have issues with blood clotting.
Rheumatoid arthritis can be very painful. Patients with advanced rheumatoid arthritis often have trouble with daily life because normal movement is so unpleasant.
Deep vein thrombosis, or DVT, occurs when blood clots form in larger veins, usually in the legs. DVT can create serious damage to the legs and veins. DVT can also be quite painful and result in swelling.
The biggest danger with DVT is that a blood clot will detach and travel through the veins up to the lungs. This condition is called a pulmonary embolism. The clot can prevent blood from traveling through the lungs and to other parts of the body. In some cases, a pulmonary embolism can be life threatening.
Because Taiwan keeps a national database of health insurance information, the researchers were able to observe the entire Taiwanese population from 1998 to 2008.
The researchers identified people who had rheumatoid arthritis and compared them with a random group of people without arthritis. They looked specifically at rates of DVT and pulmonary thromboembolism.
They found that patients with rheumatoid arthritis had a significantly increased risk of developing vein issues than the general population.
The researchers claimed that the association between DVT and rheumatoid arthritis might be explained by a theory called "Virchow's triad." This theory states that DVT is caused by slow blood flow, injury to the vein wall and viscous blood (thicker, stickier blood). The combination of inflammation and decreased mobility from rheumatoid arthritis could be a reason why individuals with rheumatoid arthritis have a higher risk for blood clots.
However, the study authors did not identify a definite cause for the link between DVT and rheumatoid arthritis. Other factors could play a part.
The authors concluded that individuals with rheumatoid arthritis should be aware of their increased risk of DVT. Also, doctors should look out for development of vein issues with patients who have already developed rheumatoid arthritis.
Awareness of vein issues is particularly important when a person first finds out they have rheumatoid arthritis. As the authors noted, "The highest risk of developing DVT appeared in the first years of rheumatoid arthritis diagnosis."
The study was published in the Annals of Rheumatic Diseases in August.
The research was supported by grants from the study hospital and various Taiwan health research organizations. No competing interests were disclosed by the authors.