The age- and sex-standardized prevalence of each of the co-morbidities considered was increased in at least one of the inflammatory RMDS compared with the control population (Table 2, Fig. 1). The prevalence of all co-morbidities considered was increased in participants with RA compared with controls (Table 2). In participants with SLE, the prevalence of the following co-morbidities was particularly increased: angina [SMR (95% CI): 3.1 (2.2, 4.2)], myocardial infarction [3.3 (2.1, 4.9)] and stroke [4.9 (3.6, 6.6)]. Participants with each of the inflammatory RMDs had an increased prevalence of the following co-morbidities compared with controls: angina [SMR (95% CI), RA: 1.9 (1.7, 2.1), PsA: 1.5 (1.1, 2.0), AS: 1.4 (1.1, 1.7), SLE: 3.1 (2.2, 4.2)], hypertension [RA: 1.2 (1.2, 1.3), PsA: 1.4 (1.3, 1.6), AS: 1.2 (1.1, 1.3), SLE: 1.4 (1.3, 1.6)] and depression [RA: 1.2 (1.1, 1.3), PsA: 1.3 (1.0, 1.7), AS: 1.5 (1.2, 1.8), SLE: 1.4 (1.0, 1.8)]. Only participants with RA had an increased prevalence of diabetes [1.5 (1.4, 1.6)] compared with the control population. Similar results were seen in sensitivity analysis comparing the prevalence of the co-morbidities in people who self-reported an inflammatory RMD and were also taking s/bDMARDs compared with the control population (Supplementary Table S2, available at Rheumatology online).

Table 2

Prevalence of co-morbidities in participants with a rheumatic/musculoskeletal disease

RAPsAASSLE
n (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioa
Myocardial
    Angina350 (0.06)1.9 (1.7–2.1)*42 (0.05)1.5 (1.1–2.0)*71 (0.05)1.4 (1.1–1.7)*41 (0.06)3.1 (2.2–4.2)*
    MI224 (0.04)1.9 (1.6–2.1)*26 (0.03)1.3 (0.8–1.9)53 (0.04)1.3 (1.0–1.7)*23 (0.04)3.3 (2.1–4.9)*
Vascular
    Stroke/ischaemic stroke180 (0.03)1.6 (1.4–1.9)*16 (0.02)1.0 (0.6–1.6)40 (0.03)1.5 (1.0–2.0)*45 (0.07)4.9 (3.6–6.6)*
    Hypertension2043 (36.5)1.2 (1.2–1.3)*345 (38.7)1.4 (1.3–1.6)*462 (34.8)1.2 (1.1–1.3)*218 (39.2)1.4 (1.3–1.6)*
Pulmonary
    Pulmonary disease (COPD/ emphysema/bronchitis)284 (5.1)2.1 (1.9–2.4)*25 (2.8)1.3 (0.8–1.9)63 (4.8)2.0 (1.6–2.6)*30 (4.7)2.4 (1.6–3.4)*
Endocrine
    Diabetes443 (7.9)1.5 (1.4–1.6)*57 (6.4)1.2 (0.9–1.6)84 (6.3)1.0 (0.8–1.3)36 (5.6)1.4 (1.0–2.0)
Psychological
    Depression367 (6.5)1.2 (1.1–1.3)*62 (7.0)1.3 (1.0–1.7)*94 (7.1)1.5 (1.2–1.8)*56 (8.7)1.4 (1.0–1.8)*
RAPsAASSLE
n (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioa
Myocardial
    Angina350 (0.06)1.9 (1.7–2.1)*42 (0.05)1.5 (1.1–2.0)*71 (0.05)1.4 (1.1–1.7)*41 (0.06)3.1 (2.2–4.2)*
    MI224 (0.04)1.9 (1.6–2.1)*26 (0.03)1.3 (0.8–1.9)53 (0.04)1.3 (1.0–1.7)*23 (0.04)3.3 (2.1–4.9)*
Vascular
    Stroke/ischaemic stroke180 (0.03)1.6 (1.4–1.9)*16 (0.02)1.0 (0.6–1.6)40 (0.03)1.5 (1.0–2.0)*45 (0.07)4.9 (3.6–6.6)*
    Hypertension2043 (36.5)1.2 (1.2–1.3)*345 (38.7)1.4 (1.3–1.6)*462 (34.8)1.2 (1.1–1.3)*218 (39.2)1.4 (1.3–1.6)*
Pulmonary
    Pulmonary disease (COPD/ emphysema/bronchitis)284 (5.1)2.1 (1.9–2.4)*25 (2.8)1.3 (0.8–1.9)63 (4.8)2.0 (1.6–2.6)*30 (4.7)2.4 (1.6–3.4)*
Endocrine
    Diabetes443 (7.9)1.5 (1.4–1.6)*57 (6.4)1.2 (0.9–1.6)84 (6.3)1.0 (0.8–1.3)36 (5.6)1.4 (1.0–2.0)
Psychological
    Depression367 (6.5)1.2 (1.1–1.3)*62 (7.0)1.3 (1.0–1.7)*94 (7.1)1.5 (1.2–1.8)*56 (8.7)1.4 (1.0–1.8)*
a

Age- and sex-standardized morbidity ratio. The reference population comprised participants without any of the four rheumatic/musculoskeletal diseases being studied.

*

P < 0.05. MI: myocardial infarction; COPD: chronic obstructive pulmonary disease.

Table 2

Prevalence of co-morbidities in participants with a rheumatic/musculoskeletal disease

RAPsAASSLE
n (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioa
Myocardial
    Angina350 (0.06)1.9 (1.7–2.1)*42 (0.05)1.5 (1.1–2.0)*71 (0.05)1.4 (1.1–1.7)*41 (0.06)3.1 (2.2–4.2)*
    MI224 (0.04)1.9 (1.6–2.1)*26 (0.03)1.3 (0.8–1.9)53 (0.04)1.3 (1.0–1.7)*23 (0.04)3.3 (2.1–4.9)*
Vascular
    Stroke/ischaemic stroke180 (0.03)1.6 (1.4–1.9)*16 (0.02)1.0 (0.6–1.6)40 (0.03)1.5 (1.0–2.0)*45 (0.07)4.9 (3.6–6.6)*
    Hypertension2043 (36.5)1.2 (1.2–1.3)*345 (38.7)1.4 (1.3–1.6)*462 (34.8)1.2 (1.1–1.3)*218 (39.2)1.4 (1.3–1.6)*
Pulmonary
    Pulmonary disease (COPD/ emphysema/bronchitis)284 (5.1)2.1 (1.9–2.4)*25 (2.8)1.3 (0.8–1.9)63 (4.8)2.0 (1.6–2.6)*30 (4.7)2.4 (1.6–3.4)*
Endocrine
    Diabetes443 (7.9)1.5 (1.4–1.6)*57 (6.4)1.2 (0.9–1.6)84 (6.3)1.0 (0.8–1.3)36 (5.6)1.4 (1.0–2.0)
Psychological
    Depression367 (6.5)1.2 (1.1–1.3)*62 (7.0)1.3 (1.0–1.7)*94 (7.1)1.5 (1.2–1.8)*56 (8.7)1.4 (1.0–1.8)*
RAPsAASSLE
n (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioan (%)Standardized morbidity ratioa
Myocardial
    Angina350 (0.06)1.9 (1.7–2.1)*42 (0.05)1.5 (1.1–2.0)*71 (0.05)1.4 (1.1–1.7)*41 (0.06)3.1 (2.2–4.2)*
    MI224 (0.04)1.9 (1.6–2.1)*26 (0.03)1.3 (0.8–1.9)53 (0.04)1.3 (1.0–1.7)*23 (0.04)3.3 (2.1–4.9)*
Vascular
    Stroke/ischaemic stroke180 (0.03)1.6 (1.4–1.9)*16 (0.02)1.0 (0.6–1.6)40 (0.03)1.5 (1.0–2.0)*45 (0.07)4.9 (3.6–6.6)*
    Hypertension2043 (36.5)1.2 (1.2–1.3)*345 (38.7)1.4 (1.3–1.6)*462 (34.8)1.2 (1.1–1.3)*218 (39.2)1.4 (1.3–1.6)*
Pulmonary
    Pulmonary disease (COPD/ emphysema/bronchitis)284 (5.1)2.1 (1.9–2.4)*25 (2.8)1.3 (0.8–1.9)63 (4.8)2.0 (1.6–2.6)*30 (4.7)2.4 (1.6–3.4)*
Endocrine
    Diabetes443 (7.9)1.5 (1.4–1.6)*57 (6.4)1.2 (0.9–1.6)84 (6.3)1.0 (0.8–1.3)36 (5.6)1.4 (1.0–2.0)
Psychological
    Depression367 (6.5)1.2 (1.1–1.3)*62 (7.0)1.3 (1.0–1.7)*94 (7.1)1.5 (1.2–1.8)*56 (8.7)1.4 (1.0–1.8)*
a

Age- and sex-standardized morbidity ratio. The reference population comprised participants without any of the four rheumatic/musculoskeletal diseases being studied.

*

P < 0.05. MI: myocardial infarction; COPD: chronic obstructive pulmonary disease.

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