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Polymyalgia rheumatica (PMR), a common inflammatory rheumatologic condition, could increase cardiovascular risk, especially among younger patients.

Researchers from Keele University followed 3,249 patients with PMR and 12,735 matched controls for a median of 7.8 years. Vascular events were 2.6 times commoner among PMR patients than controls (36.1 and 12.2 per 1,000 person-years respectively).

The increased risk associated with PMR was similar for cerebrovascular (hazard ratio [HR] 2.3), cardiovascular (HR 2.7) and peripheral vascular (HR 2.8) events, after adjusting for age, sex and vascular risk factors. The risk for cerebroand cardiovascular events peaked during the first six to 12 months after diagnosis of PMR. The increased risk of vascular events was similar in men and women with PMR (adjusted HR 2.5 and 2.7 respectively). However, PMR patients aged 50 to 59 years at diagnosis showed a five-fold increased risk of a vascular event, which then declined with age (60-69 years: HR 2.9; 70-79 years: HR 2.3; and at least 80 years: HR 2.6).

Healthcare professionals should identify and aggressively manage vascular risk factors in polymyalgia rheumatica patients, the authors say, and further research should investigate the underlying mechanisms, in particular the relative importance of traditional risk factors, inflammation and therapeutic steroids in driving the increased cardiovascular risk in people with PMR.