The August 2008 issue of the Harvard Heart Letter reports that rheumatoid arthritis doubles a person's risk of heart attack or cardiac arrest. Heart disease risk is even higher with lupus, and a new study suggests that gout, another common kind of arthritis, is also linked to cardiovascular disease.

Rheumatoid arthritis, lupus, and related autoimmune disorders are caused by a misguided immune system. Certain white blood cells, which ordinarily protect the body from infection, attack its tissues instead. Although no one knows exactly how these conditions are connected to cardiovascular disease, it is possible they all spring from the same source-inflammation.

Inflammation is an essential part of the body's defenses. In people with rheumatoid arthritis and lupus, though, inflammation turns against the body and damages joints and other tissues. In heart disease, inflammation kicks off artery-clogging atherosclerosis, keeps it smoldering, and influences the formation of clots, the ultimate cause of heart attacks and many strokes.

Controlling rheumatoid arthritis or lupus with medications that calm inflammation may be a good start toward reducing the excess risk of heart disease. Some studies show that using medications like Remicade and Humira reduces the likelihood of having heart attacks. Statins and baby aspirin may also help.

For now, the Harvard Heart Letter suggests that the best way to control heart risk is by paying attention to diet, weight, exercise, blood pressure, and cholesterol.

Also in this issue:

Hypertension and diabetes Heart failure: Hope vs. reality Ways to quit smoking Beta blockers and surgery DASH diet ignored How long on Plavix? Hernia surgery while taking Plavix Community heart check-ups Sotalol side effects

The Harvard Heart Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $28 per year. Subscribe at health.harvard/heart

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For this study, Dr. Fan and other researchers evaluated data from 1,529 participants of the 1999-2002 National Health and Nutrition Examination Survey. They restricted their analysis to current drinkers (participants who consumed at least 12 alcoholic drinks in 12 months) aged 20 to 84 years. The survey included both an interview and a physical examination that included a blood test. Measures of alcohol consumption included usual quantity consumed, drinking frequency, and frequency of binge drinking.

"Since more than half of current drinkers in our study drank in excess of the Dietary Guidelines limits and reported binge drinking, prevention efforts should focus on reducing alcohol consumption to safer levels," said Dr. Fan. "Unfortunately, few physicians screen their patients about alcohol use or are knowledgeable about guidelines that define low-risk or moderate drinking."

Dr. Fan went on to say that public health messages should emphasize the potential cardiometabolic risk associated with drinking in excess of national guidelines and binge drinking.

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