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Résumé (anglais)

OBJECTIVE: To estimate gender-specific effects of arthritis and activity limitation on incident heart disease in a nationally representative Canadian longitudinal population-based survey. METHODS: Information on sociodemographic variables, self-reported physician-diagnosed chronic conditions (including arthritis and heart disease), activity limitation, and traditional risk factors, was collected every 2 years from 1994/95 through 2010/11 as part of the longitudinal Canadian National Population Health Survey (NPHS). Deaths due to ischemic heart disease (ICD-10 codes I20-I25) and heart failure (ICD-10 codes I50.0- I50.9) were confirmed against the Canadian Vital Statistics Database. Discrete-time survival analysis stratified by gender was used to estimate effects of arthritis and activity limitation on first heart disease event occurrence. RESULTS: The study included 12, 591 participants with no prior history of heart disease and 1,783 incident heart disease events. After adjusting for common risk factors, arthritis was associated with a significant increased risk of incident heart disease in women (Adjusted OR: 1.58, 95% CI: 1.23-2.02). Even higher risks were reported in women with arthritis and activity limitation (OR: 2.19, 95% CI: 1.61-2.97). Arthritis was not associated with incident heart disease in men, except for when also reported with activity limitation (OR: 1.60, 95% CI: 1.14-2.26). CONCLUSION: Women with arthritis and men with arthritis and activity limitation have significant excess risks for developing heart disease in the general population. These findings point to the need for improved access to arthritis care, cardiovascular prevention strategies particularly in women with arthritis, and directed interventions towards prevention of activity limitation.