Greater stiffness in the joints, arteries, and skin may be a common factor driving both rheumatoid arthritis severity and heightened cardiovascular disease risk, according to a recent study.

In the study, published in RMD Open, investigators explored the hypothesis that constitutional stiffness—a common biomechanical factor—may contribute to both rheumatoid arthritis (RA) severity and excess cardiovascular disease (CVD). The study included 58 patients with anticyclic citrullinated peptide-positive RA and 57 controls. The investigators aimed to determine if stiffness in articular, arterial, and skin tissues could serve as a shared determinant of RA progression and CVD risk.

The investigators found correlations between higher articular, arterial, and skin stiffness and increased RA severity, as measured by radiographic progression. In patients with severe RA, defined as a radiographic progression rate greater than 1.3 mSharp points per year, stiffness was greater in the right fifth metacarpophalangeal joint, skin, and arteries. Patients requiring biological disease-modifying antirheumatic drugs showed similar trends. For instance, 60% of the patients with high articular stiffness (Beighton Score 0) had high radiographic damage compared with only 33% with moderate stiffness (Beighton Score 1 to 3).

Additionally, arterial stiffness, measured by carotid-femoral pulse wave velocity (CF-PWV), was higher in the patients with RA (10.1 m/s) than in controls (9.1 m/s), with a 14% increased risk of cardiovascular events per 1 m/s increase in CF-PWV. This increase in arterial stiffness correlated with both articular and skin stiffness, which supported the hypothesis that constitutional stiffness may contribute to both RA severity and CVD risk.

The findings indicated a potential role for assessments of articular, arterial, and skin stiffness in predicting RA severity and CVD risk. However, further prospective studies are needed to explore the causal relationship between constitutional stiffness, RA progression, and cardiovascular risk.

Full disclosures can be found in the published study.