Purpose: To explore the rheumatoid arthritis (RA)-cardiovascular diseases (CVD) association in relative and absolute risk scales among US adults aged ≥20 years over time and the effect modification of the association by age.
Methods: We analyzed aggregated data from all ten continuous National Health and Nutrition Examination Survey cycles. A sample of 35,062 complete-case subjects was considered. The design-based regressions were used to investigate the associations in relative and absolute scales.
Results: In relative scale, the CVD odds ratio was 2.32, 2.19, and 1.97 among adults with RA than no arthritis in 1999-2006, 2007-2012, and 2013-2018 cycles, respectively. This time trend was not statistically significant. The absolute risk estimates were 11, 10, and 9 per 100 CVD events. We also observed a significant effect modification by age; the higher relative risk among younger adults (<50 years) with RA and higher absolute risk in older adults (≥80 years) with RA were consistent across survey cycles.
Conclusions: There is a significant association between RA and CVD among US adults in both relative and absolute risks. Moreover, age is a significant effect modifier for this association; but with opposing age-related trends in relative and absolute scales.
Keywords: Cardiovascular disease; Effect modification; Rheumatoid arthritis.
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