By David Douglas

"Our study," Dr. Antonio Naranjo told Reuters Health, "demonstrated that the time of exposure both to disease-modifying anti-rheumatic drugs and biological agents is associated with a reduction of the risk of cardiovascular events."

Naranjo, of the University of Las Palmas de Gran Canaria, Spain, and colleagues came to this conclusion after studying more than 4300 rheumatoid arthritis patients from 15 countries.

The researchers found that most traditional risk factors, such as high blood pressure, high cholesterol and diabetes were significantly associated with the risk of cardiovascular disease, but obesity and being physically inactive were not.

The team also found a link between the presence of manifestations of rheumatoid arthritis outside the joints, such as inflammation of blood vessels, and heart attack. Being male also carried a higher risk for any cardiovascular event.

However, after adjustment, the researchers found that prolonged exposure to certain anti-arthritis agents -- namely, methotrexate, leflunomide, sulfasalazine, glucocorticoids and biologic agents -- substantially reduced the risk of cardiovascular death.

"Methotrexate, other disease-modifying anti-rheumatic drugs and biologic agents could reduce the extra risk of myocardial infarction (heart attack) and stroke that patients with rheumatoid arthritis have, through the control of inflammation," suggested Naranjo

"The practical consequence of our work," he added, "is that in patients with rheumatoid arthritis, especially in the most severe cases, there has to be control of both the classic cardiovascular risk factors and the inflammatory activity of the disease."