More than half of adults with heart disease also had arthritis, and they were 30% more likely to be physically inactive than were those with heart disease alone, in a survey of 757,959 Americans.
The Centers for Disease Control and Prevention analyzed data from all 50 states in the 2005 and 2007 Behavioral Risk Factor Surveillance System. In telephone interviews, 3% of respondents said they had been diagnosed with heart disease alone, 23% reported a diagnosis of arthritis alone, 4% said they had both heart disease and arthritis, and 70% had neither condition.
Arthritis was present in 57% of the respondents with heart disease, compared with 27% of the total population, J. Bolen, Ph.D., and associates reported (MMWR 2009;58 [No. 7]:165–9).
People with heart disease and arthritis had the highest rate of inactivity—29%—compared with rates of 21% in people with heart disease alone, 18% in people with arthritis alone, and 11% in those who had neither heart disease nor arthritis, reported Dr. Bolen of the CDC's National Center for Chronic Disease Prevention and Health Promotion, division of adult and community health.
After adjustment for the effects of age, sex, race or ethnicity, education level, and body mass index, inactivity was 30% more likely in those with heart disease and arthritis, compared with people who had heart disease alone.
Physicians might better address the effects of heart disease and arthritis by integrating interventions for these co-occurring conditions, the investigators suggested. Efforts to help patients become more physically active could benefit those with one or both conditions by improving physical function and lowering blood pressure and LDL-cholesterol levels, they wrote.
Some specialized educational interventions such as the Chronic Disease Self Management Program and the Arthritis Foundation Self-Help Program can help people with arthritis increase physical activity and manage pain. Exercise programs that are appropriate for adults with heart disease and arthritis include EnhanceFitness, the Arthritis Exercise Program, and the Arthritis Foundation Aquatics Program, wrote Dr. Bolen and colleagues. Self-directed low-impact activities such as walking, swimming, and biking also can be appropriate for people with both heart disease and arthritis.
Previous research suggests that people with arthritis may have greater pain initially when they start to exercise, but continued exercise reduces pain symptoms in the long term.
The risk of having one or both conditions increased with age. Men had a higher prevalence of heart disease alone (4%) or heart disease plus arthritis (4%) compared with women (2% and 3.5%, respectively). Women were more likely to have arthritis alone (27%) compared with men (19%). Whites were more likely than were blacks to have one or both conditions. Each of these comparisons between subgroups was significant.
The Behavioral Risk Factor Surveillance System did not collect data for arthritis and heart disease in all states in 2006, so the investigators focused on 2005 and 2007 data. This study, which supports the results of previous analysis, is the first to use a national population-based sample to quantify the relationship between inactivity and heart disease, arthritis, or both.
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