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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, African Continental Ancestry Group, Aged, Arthritis, Rheumatoid, Atherosclerosis, European Continental Ancestry Group, Female, Humans, Hypertension, Male, Middle Aged, National Health Programs, Prevalence, Private Sector, Public Sector, Regression Analysis, Risk Factors, South Africa, Vulnerable Populations.
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Does public healthcare attendance associate with enhanced conventional and non-conventional atherosclerotic cardiovascular disease risk burdens in established rheumatoid arthritis? Context: To assess whether public healthcare attendance associates with altered atherosclerotic cardiovascular disease risk in established rheumatoid arthritis (RA). We determined disparities in major conventional (hypertension, dyslipidemia, smoking and diabetes), other conventional (underweight, obesity, metabolic syndrome, chronic kidney disease, alcohol use, tension, depression and body height) and non-conventional (current and cumulative inflammation markers) cardiovascular risk factors between 424 consecutive public and 202 private healthcare patients in mixed regression models. Eighty-one percent of public healthcare patients were black (67%) or caucasian (14%) and 83% of private healthcare cases were caucasian. Seventy percent of the patients had > or = 1 major conventional risk factor. After adjustment for age, gender, ethnic origin and statin use when appropriate, public healthcare attendance associated with the prevalence of hypertension (odds ratio (OR) [95%CI]=1.72 [1.03, 2.85]), having > or = 1 major conventional risk factor (OR [95%CI]=1.83 [1.09, 3.07]) and an increased mean (SD) number of such risk factors (p=0.03), metabolic syndrome frequency (OR [95%CI]=1.90 [1.07, 3.40]), alcohol use (OR [95%CI]=0.07 [0.03, 0.18]), shorter stature (p<0.0001), higher tension (p=0.02) and depression score (p<0.0001) and higher inflammatory markers including the disease activity score in 28 joints (p=0.005), C-reactive protein concentration (p=0.0006), Health Assessment Questionnaire disability index (p<0.0001), and number of deformed joints (p<0.0001). In sensitivity analyses performed in caucasian Africans, public healthcare attendance associated with increased frequencies of each major conventional risk factor (OR=2.06 to 3.69) and higher other conventional and non-conventional mediated cardiovascular risk.
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Public healthcare patients with established RA experience markedly enhanced conventional and non-conventional cardiovascular risk burdens. Final Decision: yes