Rheumatoid arthritis is the most common inflammatory form of arthritis and affects approximately two million Americans. It is an autoimmune disease. Autoimmune diseases are characterized by abnormal function of the immune system. For whatever reason (and that reason is still unknown), the immune system attacks healthy tissue. In rheumatoid arthritis, joint tissues such as ligaments, tendons, and muscles, are attacked and become inflamed. Symptoms that develop include painful, swollen, tender joints. The small joints in the hands and feet are the most commonly affected. Other prominent symptoms include fatigue and stiffness.
Rheumatoid arthritis is a systemic disease meaning it attacks many different organ systems. One organ system that can be affected are the blood vessels. This inflammation of blood vessels is called vasculitis. It is especially dangerous because vessels carry blood throughout the body: to the brain, lungs, skin, kidneys, and heart. “Shutdown” of organs occurs. Why? As the inflammation of the blood vessels progresses, the blood vessels are no longer able to transport blood.
Vasculitis due to rheumatoid arthritis can lead to heart attack and stroke. (Roman MJ, et al. Preclinical Carotid Atherosclerosis in Patients with Rheumatoid Arthritis. Annals Int Med 2006; 144: 249-256)
A sidebar to this is the eye involvement that can occur. Inflammation of the sclera- the white part of the eye- can lead to blindness as a result of perforation or hemorrhage.
An interesting side light to this is that several studies provide evidence that long-term smoking contributes to the immune system’s malfunctioning. This most likely explains why smoking is associated with increased severity of the disease. This is also why smoking and rheumatoid arthritis make a terrible combination. Smoking causes premature atherosclerosis and rheumatoid arthritis does also.
If untreated, rheumatoid arthritis significantly shortens life span by an average seven to eight years. It increases the risk for heart attack and stroke. Sixty percent of untreated patients are disabled and dependent on others to take care of them within 10 years.
One other factor that contributes to the shortened lifespan is the increased incidence of lymphoma that occurs in patients with RA.