Women with rheumatoid arthritis (RA) have higher respiratory and cardiovascular disease-derived mortality than those without RA, according to a recent study.

“Rheumatoid Arthritis and Mortality Among Women During 36 Years of Prospective Follow-Up: Results From the Nurses’ Health Study,” was compiled by researchers at the Brigham and Women’s Hospital and Harvard Medical School in Boston, and published in Arthritis Care and Research.

Previous studies had suggested that RA patients may be higher risks for cardiovascular disease, cancer, respiratory disease, and serious infections compared to the general population, even when disease-modifying drugs for RA are used. But most studies addressed the risk in RA patients only, or did not take into account factors such as smoking or body mass index, which could influence RA susceptibility and mortality.

The research team led by Dr. Jeffrey A. Sparks from the Department of Medicine’s Division of Rheumatology, Immunology, and Allergy at Brigham and Women’s Hospital, examined 119,209 women from the Nurses’ Health Study who reported no connective tissue disease at enrollment in 1976, and then were evaluated through biennial questionnaires for up to 36 years.

Follow up on the women indicated that 964 women developed RA, 31.8% of whom had died compared to 24.1% of deaths in the non-RA group. Results showed that women with RA had a 40% increase in risk of death compared to the general population.

Among the RA patients who died, 26% died of cancer, 23% from cardiovascular disease, and 44% from respiratory disease. The researchers found that RA patients had twice the respiratory disease mortality.

The study also found that seropositive RA patients, positive for rheumatoid factor and anti-cyclic citrulinated peptide blood test, had nearly three times higher mortality than women without RA, but no association was found between seronegative RA and respiratory disease-related mortality. Still, both seronegative and seropositive RA subtypes were associated with increased cardiovascular disease–related mortality.

Researchers suggested that clinicians be aware of increased mortality risk among RA patients, particularly respiratory disease related mortality in seropositive RA.