RISK FACTOR | CARDIOVASCULAR PREVENTION STRATEGIES |
---|---|
Smoking | Counseling, nicotine patches or gum, bupropion, varenicline |
Hyperlipidemia | Diet, exercise, reducing alcohol consumption,* statins, minimizing use of corticosteroids, antimalarials* |
Diabetes | Counseling, diet, exercise, oral hypoglycemic agents, insulin |
Insulin resistance | Counseling, diet, controlling inflammation (DMARDs or biologics), PPAR agonists* |
Obesity | Counseling, diet, exercise, minimizing use of corticosteroids |
Hypertension | Frequent blood pressure monitoring, diet, exercise, stress management, antihypertensive drugs, minimizing use of NSAIDs and corticosteroids |
High homocysteine level | Folic acid supplementation with methotrexate or sulfasalazine use |
Inflammation | DMARDs, biologics, NSAIDs, statins,* PPAR agonists* |
Thrombotic risk | Low-dose acetylsalicylic acid (consider anticoagulation when other thrombosis risk factors are present) |
Family history of CVD | Counseling, monitoring risk factors |
CVD—cardiovascular disease, DMARD—disease-modifying antirheumatic drug, NSAID—nonsteroidal anti-inflammatory drug, PPAR—peroxisome proliferator–activated receptor.
↵* Not enough evidence to suggest standard of care.
Data from Kaplan.1