So today we're going to talk about osteoarthritis and heart disease
you know what if I don't know if I'll ever learn it maybe I'm too arrogant
when patients say oh yeah I've got this and when I say oh no that's not right a few of
them have said you know I've got maybe some increased risk because I've got osteoarthritis
they were right but again it's still not like the inflammatory arthritis so let's talk about it
osteoarthritis and heart attack and stroke risk OA we'll call it OA and cardiovascular disease
CVD they're two of the most prevalent conditions affecting the US population in any
aging population both are characterized by slow accumulation of disease or pathological change
eventually leading to adverse health outcomes they share several risk factors including
age and obesity what else has age and obesity well diabetes prediabetes what is OA osteoarthritis
it's the most common form of arthritis for sure it's a highly prevalent it happens a lot very
common chronic disorder one of the leading causes of disability among the elderly as you see these
pictures on the right here we've shown a lady with what we call joint mice you know swollen joints
from osteo problems and we'll show a picture of rheumatoid arthritis in a few minutes rheumatoid
arthritis tends to hit these joints the MP joints the joints between the fingers and the hands
as you see with osteo osteo hits the IP joints the interphalangeals these joints out here the
knuckles that's a generalization but again that's what you usually see one of the most common areas
to see significant osteoarthritis you see on these two pictures on the right in the knees it is a big
deal osteoarthritis occurs when the protective cartilage that cushions the ends of bones
wears down over time and it's associated with increasing age female gender obesity injury at
the joints occupation in other words do you work with your hands do you work walking or running
physical activity are you a runner a jogger although OA is the most common rheumatic disease
I probably should have changed that to say arthritic disease because people when they think
rheumatic maybe they think rheumatoid it's the most common arthritic disease very little known
is known about it though especially in terms of the relationship between OA osteoarthritis and
cardiovascular disease as I said I was unaware of it I had not thought it through and yes
you know to credit on that position it's a fairly subtle relationship but once you start thinking
about it it makes sense physical inactivity if you've got major joint on knee problems
how are you going to get a lot of high intensity intervals aerobics you can that's one of the
things that we do is help people problem solve in that area and Janice is very good in that space
but again it has an impact chronic inflammation again this is the significant difference between
OA osteoarthritis and rheumatoid arthritis or psoriatic arthritis the inflammatory arthritis
osteo is not an inflammatory arthritis it doesn't get nearly as much inflammation as the others
but there's still some inflammation that's the point they're making here it's referred
to as a degenerative disease but recent studies have shown there is synovium or that padding
inflammation in that area and that plays a role in the development of osteo muscle weakness you
remember we've said multiple times especially after we get to age 65 and beyond one of our
absolute biggest risk factors is loss of muscle mass well guess what if you can't move your knee
very much in weight bear because of osteo in that knee guess that what that's going to do
to the biggest muscles in your body your thigh muscles your hamstrings your quads and your calves
so that is a very very big deal non-steroidals non-steroidal anti-inflammatory drugs NSAIDs
these are commonly used to treat OA and NSAIDs are associated with increased risk of cardiovascular
disease so OA and heart disease so let's start taking a look at some of the studies here's one
of them in BMJ British Medical Journal Open the purpose was to determine the association between
osteo and cardiovascular disease it used data from the Canadian Community Health Survey
cycles 2000 2001 2002 all the way up to 2005 they identified 41,000 self-reported osteo
sufferers and they selected a one-to-one match
for each of those sufferers and they matched them by age gender and survey cycles
so what that does then by the way is that it's if you adjust for age then all of a sudden
it's been adjusted out and it cannot be one of the reasons when you find a difference
if you find more osteo or more heart attack in the osteo group and you've adjusted it for age
then it's not age that's causing that problem so the primary outcome that they were looking at is
self-reported heart disease secondary outcomes was were my heart attack myocardial infarction
angina heart failure and stroke so they did some sophisticated statistical activities it's
called multivariable logistic log regression or logistic regression obviously not going to go
down that bunny hole but they estimated odds ratios and looked at socio-demographic status
obesity physical activity smoking status fruit and vegetable consumption medication use diabetes
hypertension and chronic obstructive lung disease the results osteo is significantly associated with
any heart disease angina and heart failure in both men and women after controlling for confounders
like age so the odds of heart disease were 45 percent higher in persons with osteo compared
with the age match controls most associations appeared stronger in women than in men and as
you remember osteo is more common in women than men anybody know the reason for that I don't I
will say that joint injury is usually adjusted and protected by the muscles by development of
muscles around the joint so greater musculature around joints may be one of the reasons why men
tend to have less osteo I certainly don't know the answer to that whether that's the truth and
I don't think anybody else does either but it's an interesting theory I'd love to see some science
around that space why women have a greater risk for osteo anyway women have a greater risk for
osteoassociated with cardiovascular disease as well osteo was significantly associated
with heart attack among women only now other types of heart disease with men as well but it was not
associated with stroke now what does that mean is that real I don't know to me it sounds like just
what we call a signal a research signal something you find once in one study but you never know
I think that's why you always hear at the end of these studies we need to have more research
so I'd like to talk with you a minute about the webinar people don't understand what the webinar
is it's actually a great way to get some access to health care that you're just not going to
get any other way you actually get the lab tests yourself for at a local lab a Quest lab near you
for the inflammation panel and the OGTT and the insulin survey these are things inflammation and
prediabetes that your doctor just does not know about and here's the thing Harvard Health and many
others have said look sudden death is not always so sudden the Hollywood picture that it's a bolt
out of the blue is not realistic it's more like real lightning preceded by clouds wind and rain
stop that metabolic storm before the lightning strikes and here's where that metabolic storm
comes from it's inflammation and it has to do usually with prediabetes so again we actually
get labs we go over them in the webinar and then you can start finding out how you can
prevent that heart attack others said that you couldn't even predict we can show you how thanks