The association between polymyalgia rheumatica and vascular disease; a systematic review

Abstract

Objectives

To systematically identify and appraise the existing literature on the association between PMR and vascular disease.

Methods

The MEDLINE, EMBASE, CINAHL and Cochrane databases were searched from inception till September 2010. Search criteria included observational studies containing patients with isolated PMR reporting on a vascular outcome. Data was extracted and articles were quality assessed.

Results

The database search identified 545 articles. 8 articles, reporting on 7 unique studies, were included in the final review. 4 studies reported on vascular mortality and 3 studies reported on other vascular outcomes. 4 of the studies reported statistically significant positive associations between PMR and vascular disease and 3 studies reported no statistically significant results. The heterogeneity of results was investigated; the strongest explanatory variable was that 2 of 3 studies which reported non-significant results were prospective, whereas all of those reporting significant results were retrospective.

Conclusions

There is some evidence to suggest that, like other inflammatory rheumatic disorders, PMR may be linked with an increased risk of vascular disease. Further studies are required to quantify the level of risk, to determine whether patients with PMR should be actively screened for cardiovascular disease and its risk factors. © 2012 by the American College of Rheumatology