Aerobic capacity is associated with disease activity and cardiovascular risk factors in early rheumatoid arthritis.
Lars Ångström, Kristina Hörnberg, Björn Sundström and 2 others
PMID 31913553WHAT IT FOUND
In early rheumatoid arthritis, higher estimated aerobic capacity was linked to lower disease activity, better cardiovascular risk markers, and more favourable body composition.
Key findings
01Patients with estimated aerobic capacity above the median had more favourable disease activity and cardiovascular risk factor values than those below the median.
02Aerobic capacity was negatively associated with age, inflammation, blood pressure, carotid thickness, arterial stiffness, triglycerides, body fat percentage, waist circumference, and estimated 10-year cardiovascular disease mortality risk.
03After adjustment for age and sex, associations remained with several markers, and the final model linked aerobic capacity to body fat percentage and triglycerides.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot show that aerobic capacity causes lower disease activity or cardiovascular risk. Patients with severe functional limitations, severe cardiopulmonary or neurological disease, or beta blocker treatment were excluded, so the results may not apply to the most limited patients. The higher aerobic capacity group was younger, and some associations with disease activity, inflammation, carotid thickness, and arterial stiffness did not remain after age and sex adjustment. Patients were receiving standard rheumatoid arthritis drug treatment, including disease modifying drugs, biological agents, and corticosteroids, so associations may reflect disease or treatment rather than aerobic capacity alone.
Declared interests
The authors declared no conflict of interest. Funding came from Svenska Sällskapet för Medicinsk Forskning, Swedish Society for Medical Research, Swedish Heart-Lung Foundation, Swedish Rheumatism Association, and Karolinska Institute.
The easy way to misread this
Do not conclude that exercise improves cardiovascular risk in early rheumatoid arthritis. This study measured associations at one time and excluded patients who could not safely perform the aerobic test, so it cannot prove cause and effect.