Risk and temporal trends of heart failure subtypes in rheumatoid arthritis
Authors' conclusion
RA was most strongly associated with HFpEF and HFpEF-related death in this national-level, observational dataset. Heightened risks of HF subtypes have not improved despite advances in RA treatment.
Study context
- Population
- Veterans Health Administration, 2000–2019: patients with rheumatoid arthritis (RA) (mean age 62.5, 87.1 % male) and matched non-RA controls (mean age 61.1, 85.8 % male)5,663,151 person-years
- Participants
- 67,850 vs 570,933
- Exposure
- RA vs matched non-RA controls
- RAn = 67,850
- Non-RAn = 570,933reference
- Outcome
- Incident HF and HF-related death, classified as HFpEF and HFrEF
Methodological detailsmatched (up to 10 non-RA controls) on age, sex and Veterans Health Administration (VHA) enrollment year, conditional Cox regression
- Matched (up to 10 non-RA controls) on age, sex and VHA enrollment year
- Conditional Cox regression
Main finding
As reported in the abstract
RA vs Non-RAAdjusted hazard ratio (95 % CI)
HFpEF
1.51(1.46–1.57)
HFpEF-related death
2.05(1.76–2.39)
HFrEF
1.34(1.30–1.38)
HFrEF-related death
1.45(1.29–1.63)
Observational data: associations, not effects.
Further findings
Temporal trends in heart failure (HF) risk by RA diagnosis period (2000-2005, 2006-2011, 2012-2017)
- No improvements in HF risk over time
- linear p-for-trend >0.05 for all outcomes
HF risk in RA with elevated inflammation and seropositive RA (subgroups)
- HF risk accentuated in RA with elevated inflammation and seropositive RA
Original publication
Risk and temporal trends of heart failure subtypes in rheumatoid arthritis. Semin Arthritis Rheum. Published 14 August 2025. doi:10.
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