Rheumatoid arthritis itself isn’t fatal. But: Researchers recently discovered that having this kind of arthritis can double or even triple your risk of developing a potentially fatal condition called thromboembolism, meaning a blood clot either in a deep vein or in a lung.

And up to 30% of people who have a thromboembolism die within the month.

Because this information is so new, even if you have arthritis, chances are that your doctor hasn’t warned you about the risk—or discussed what you need to do to protect yourself…

DATABASE OF MILLIONS

The new study was conducted in Taiwan. Since 1995, that country has had a mandatory national health insurance program, so medical researchers have access to statistics on the country’s entire population of nearly 24 million people.

In this case, researchers examined more than a decade’s worth of data, identifying 29,238 people who developed rheumatoid arthritis during the study period. Then, to create a basis of comparison, they matched each arthritis patient with four arthritis-free people of the same gender and similar age. They also controlled for other conditions known to increase thromboembolism risk, including diabetes, high blood pressure, high cholesterol, atrial fibrillation (abnormal hearth rhythm), cerebral vascular disease (conditions that limit blood flow to the brain), heart failure, cancer, and lower leg fractures or surgery. The startling results…

  • Deep vein thrombosis (a clot in a deep vein, usually in the leg) was more than three times as likely to develop in rheumatoid arthritis patients as in people without rheumatoid arthritis.
  • Pulmonary embolism (a clot in the lung) was more than twice as likely to develop in people with rheumatoid arthritis than in those who did not have the disease.
  • Surprisingly, risk for both deep vein thrombosis and pulmonary embolism was greater in rheumatoid arthritis patients who were age 50 or younger, compared with older arthritis patients.

Having another condition that increased thromboembolism risk, such as diabetes, in addition to rheumatoid arthritis boosted blood clot risk even further—about six times more for deep vein thrombosis and almost five times more for pulmonary embolism.

THE CLOT CONNECTION

Why would a joint disease cause blood clots? Thromboembolism is thought to have three causes—alteration in blood flow, damage to the lining of the blood vessels and changes in the blood’s propensity to clot—and rheumatoid arthritis may affect all three of these factors. Here’s how…

  • Blood flow typically is affected by muscular movements that help push the blood through the circulatory system. (This explains why it’s so important to stay mobile after an operation, for instance.) People with rheumatoid arthritis tend to move less because of their painful, debilitating condition.
  • Inflammatory proteins circulating in the blood of rheumatoid arthritis patients can damage blood vessels.
  • People with rheumatoid arthritis have higher levels of C-reactive protein, a marker of inflammation that also indicates an increase in the blood’s viscosity (resistance to flow).

If you have rheumatoid arthritis: Click here to learn the warning signs of thromboembolism and what to do if you develop possible symptoms…to read about prevention strategies…and to find out about treatment options to discuss with your doctor.