Prevalence of Common Comorbidities in Rheumatoid Arthritis in Rural New York Compared With National Data

Daniel T Fuller; Eyal Kedar; Carly R Lovelett; Sumona Mondal; Shantanu Sur

doi:10.7759/cureus.19432

Prevalence of Common Comorbidities in Rheumatoid Arthritis in Rural New York Compared With National Data

Cureus. 2021 Nov 10;13(11):e19432. doi: 10.7759/cureus.19432. eCollection 2021 Nov.

Authors

Daniel T Fuller¹, Eyal Kedar², Carly R Lovelett², Sumona Mondal¹, Shantanu Sur³

Affiliations

¹ Department of Mathematics, Clarkson University, Potsdam, USA.
² Clinical and Rural Health Research, St. Lawrence Health, Potsdam, USA.
³ Department of Biology, Clarkson University, Potsdam, USA.

Abstract

Background Rheumatoid arthritis (RA) is a systemic autoimmune disease with multiple known comorbidities and risk factors. The rate and severity of different comorbidities among RA patients are influenced by various demographic, behavioral, and socioeconomic factors, which can vary widely between urban and rural areas. However, limited information is currently available regarding the association of comorbidities with RA in rural settings. In this study, we investigated the prevalence of common comorbidities and risk factors of RA among RA patients from a rural hospital located in rural northern New York and compared them against national patient records obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Methodology We compared de-identified patient records of 153 RA patients obtained from St. Lawrence Health (SLH) to 198 RA patients from the NHAMCS. After performing the descriptive analyses and removing outliers, two-sample tests of proportions were used for comparing the binary categories of sex, age, obesity, hypertension, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF) between the two datasets. These analyses were applied to both weighted and unweighted sets of national data, and a p-value of <0.05 was considered statistically significant. The differences were then explored at a greater resolution by binning body mass index, blood pressure (BP), COPD prevalence, and tobacco usage data across different age groups. Results A significantly higher rate of diastolic hypertension (χ² = 17.942, w = 0.232, p < 0.001) and over two times higher prevalence of COPD (χ² = 7.635, w = 0.147, p = 0.006) were observed among RA patients in the rural group. The rates of CHF were significantly different only when sample weighting was applied. When categorized by age groups, diastolic BP showed a peak at 40-49 years, coinciding with the age group for high tobacco smoking and peak disease activity in rural RA patients. Conclusions A higher prevalence of comorbidities of RA such as hypertension (diastolic) and COPD are observed in patients from northern rural New York compared to the national average. Our findings indicate that rural RA patients might have a distinct comorbidity burden, suggesting the need for larger-scale studies.

Keywords: arthritis; chronic obstructive pulmonary disease; hypertension; inflammation; obesity; smoking.