Diseases of the heart and blood vessels, such as heart attacks and stroke, are a leading cause of death and reduced cardiovascular health status in people with osteoarthritis (OA). Identifying the risk factors and frequency of heart attacks and stroke in people with OA will help to offer better ways of preventing them. Despite many people having a diagnosis of OA, there have been no previous studies that have looked at how they are assessed and treated with relation to the prevention of future heart attacks and strokes. There have also been no studies that have looked at how well treatment guidelines on the prevention of heart attacks and stroke in people with OA are followed.
This study aims to identify what leads to heart attacks and stroke in people with OA, how they are managed and if this differs to people without OA. This study will also evaluate whether people with OA have increased risk of heart attack and stroke, and more risk factors for heart attack and stroke, than people without OA.
The objective of the proposed research is to test the hypotheses that people with osteoarthritis, compared to those without, have a higher risk profile for cardiovascular disease (CVD), have an earlier presentation of CVD, are less likely to receive treatment in line with preventative treatment guidelines, and have increased health care needs.
This is a longitudinal cohort study of adults aged 35 and over with and without osteoarthritis. Descriptive statistics will be used to describe the prevalence of cardiovascular risk factors (smoking, hypertension, type 2 diabetes, overweight or obesity, dyslipidaemia) and frequency of the management (e.g whether prescribed antihypertensive, lipid lowering and anti-diabetic medication, frequency of blood tests) to determine whether this is in line with existing primary care guidelines. Cox proportional hazards modelling will be used to estimate (i) the lifetime risk of CVD, and (ii) the association between CV risk factors and the lifetime risk of CVD (adjusting for confounders) in those with and without osteoarthritis. Model performance will be evaluated using Bayesian Information Criterion (for goodness of fit), Briers score and the Calibration slope (for model calibration) and C Statistics (for discrimination).
i) Outcomes for Stage I: Longitudinal descriptive study:
1) CV risk factors (smoking, hypertension, type 2 diabetes, overweight or obesity, dyslipidaemia) recorded in primary care settings (Appendix 3-5)
2) Management of CV risk factors (proportion of taking antihypertensive prescriptions, proportion of taking lipid lowering prescriptions, proportion of taking anti-diabetic prescriptions and frequency of blood test)
ii) Outcomes for Stage II: Cohort study
1) Incident diagnosed CVDs recorded in primary care settings
2) Mortality due to CVDs
3) Specific group of CVDs (Ischaemic heart disease, heart failure, cerebrovascular disease, and peripheral vascular disease)
Dahai Yu - Chief Investigator - Keele University
Dahai Yu - Corresponding Applicant - Keele University
Mamas Mamas - Collaborator - Keele University
Ross Wilkie - Collaborator - Keele University
Xiaoyang Huang - Collaborator - Keele University
ONS Death Registration Data;Patient Level Index of Multiple Deprivation