Hand Osteoarthritis is associated With Subclinical Cardiovascular Disease in Mexican Women

Introduction: Osteoarthritis is a growingly common joint disorder affecting older adults. It is characterized by chronic low-grade inflammation, a phenomenon by itself considered a cardiovascular risk factor. However, data on its potential impact on cardiovascular disease (CVD) is scarce. Assessing hand osteoarthritis (HOA) might be advantageous when studying CVD as this particular location might be less affected by traditional cardiovascular risk factors such as overweight and physical activity. Hypothesis: HOA is associated with subclinical CVD. Methods: We cross-sectionally assessed the relationship between HOA and CVD in 1,803 women from the Mexican Teachers’ Cohort, excluding those with history of myocardial infarction, cerebrovascular disease, and rheumatoid arthritis. From 2012 to 2016, a subsample of the MTC participants from Mexico City and the states of Nuevo LeÓn, Chiapas, and YucatÅn were invited for clinical examinations in which standardized neurologists measured their carotid intima-media thickness (IMT) with ultrasound and a standardized HOA questionnaire was applied. HOA was defined as having ≥45 years, hand joint pain, and morning stiffness that lasts no longer than 30 minutes. Subclinical CVD was assessed through log-transformed IMT, and carotid atherosclerosis (CAS) was defined as mean right or left carotid IMT ≥0.8 mm or the presence of atherosclerotic plaque. Multivariable linear and logistic regression analyses were used to evaluate the association between HOA and IMT and CAS adjusting for age, state, smoking, alcohol consumption, diabetes, hypertension and body mass index. Results: Among participants with a mean age of 51 years (±4), 18.4% met the criteria for HOA, and the prevalence of CAS was 23.1%. After multivariable adjustment, women diagnosed with HOA had 1.6% (95%CI 0.2, 3.1) higher mean IMT than those without the joint disease. Similarly, women with HOA had 35% (95%CI 1.01, 1.81) higher odds of CAS. Sensitivity analyses using a less stringent definition of OA (pain regardless of stiffness), as well as incapacitating pain, did not have a significant association with CAS. Conclusion: Among middle-aged women, HOA was associated with subclinical CVD. This relation might be due to low-grade chronic inflammation, but further research is needed to clarify the underlying mechanisms, the role of screening for HAO as part of cardiovascular risk profiling, and the value of potential interventions such as anti-inflammatory drugs.