Background/Purpose: Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterised by inflammation of the synovial joints. Traditional lifestyle factors, such as smoking and poor diet, have been associated with adverse outcomes in people with RA. However, the effect of emerging lifestyle factors, such as sleep duration and sedentary behaviour, remain unclear as does their combined effect. We examined the association between an extended lifestyle score (based on traditional and emerging lifestyle factors) and all-cause mortality and major adverse cardiac events (MACE) in an RA population.

Methods: Data were sourced from the population-based cohort, UK Biobank (N = 502,503). Data were collected from 2006 to 2010 and linked to mortality and hospital admissions records. Participants with RA were assigned one point for each unhealthy lifestyle behaviour: frequent alcohol intake, four poor dietary habits (low fruit and vegetable or oily fish intake, and high processed or red meat intake), physical inactivity, short/long sleep duration, current smoker and prolonged television viewing time, giving a lifestyle score of 0-9. Participants were categorised as most healthy (score 0-2), moderately healthy (score 3-5) and least healthy lifestyle (score 6-9). Cox proportional hazards models were used to examine the association between lifestyle score categories and all-cause mortality and MACE (including myocardial infarction and stroke). All analyses were adjusted for age, sex, socioeconomic status, body mass index and other long-term conditions count.

Results: 5295 participants with RA and a lifestyle score (aged between 40 and 70; mean age (SD) 59.19 (7.10); 69.97% Female) were included in this study. There were 390 deaths and 290 MACE recorded. The adjusted hazard ratio (HR) for all-cause mortality in the least healthy category, compared with the most healthy (reference) category, was 2.42 (95% confidence interval (CI) 1.42-4.12) and 2.04 (95% CI 1.03-4.06) for MACE. The adjusted HR in the moderately healthy category, compared with the most healthy (reference) category, was 1.23 (95% CI 0.99-1.51) for all-cause mortality and 1.39 (95% CI 1.09-1.77) for MACE.

Conclusion: Combinations of unhealthy lifestyle factors are associated with higher risk of adverse health-related outcomes in people with RA. People in the least healthy category experience over twice the risk of all-cause mortality or MACE compared to those in the most healthy category. Examining the impact of combined traditional and emerging lifestyle factors may inform health policy reducing avoidable adverse health-related outcomes.

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-an-extended-lifestyle-score-and-adverse-health-related-outcomes-in-people-with-rheumatoid-arthritis-a-study-of-5295-uk-biobank-participants/