Arthritis and heart disease: The surprisingly strong link

Heart Health

by Sean Haslam, MD, FRCSC, FAAOS

Feb 24, 2020

Other than both being potentially serious conditions affecting millions of people, osteoarthritis and heart disease may not seem to have that much in common. Osteoarthritis causes pain and stiffness in the joints, while heart disease impacts the heart and blood vessels. Musculoskeletal system versus circulatory system. Separate issues, right?

Actually, there is a relationship between the two conditions. It’s a relationship that has become increasingly scientifically intimate over the last 10 years.

Sean Haslam, MD, FRCSC, FAAOS, an orthopedic specialist on the medical staff at Baylor Scott & White Medical Center – Centennial, has seen the relationship evolve. He shares his views on the factors behind this link — and how you can help prevent both.

Q: What is the relationship between osteoarthritis and heart disease, and how has it changed?

Originally, it was thought that it was all about age. People who are older tend to have more cardiovascular risk, and as we age, we tend to have more risk of osteoarthritis as cartilage wears away.

In recent years, there has been a more direct link between the two, although there is some disagreement in the scientific literature in terms of the exact nature of that link.

Some studies seem to indicate that heart disease may be related to arthritis due to a chemical process. However, a lot of the literature in the orthopedic world seems to suggest that osteoarthritis decreases activity level, which can as a result raise your risk of heart disease.

So, the debate is this: does heart disease play a role in raising the risk of osteoarthritis? Or is it that osteoarthritis causes decreased activity which is a risk for the development or worsening of heart disease?

Twenty years ago, most orthopedic surgeons would probably have agreed there was no chemical link between heart disease and arthritis. But because of some of the newer research that has come out, the door is now open to explore that, and we need to be openminded about it.

Q: Has care changed for patients with arthritis who also have or are at risk for heart disease?

I definitely think there is more of a medical focus on getting patients with osteoarthritis “heart healthy,” so to speak.

If you can lessen risk factors for heart disease through medication, diet and lifestyle, it’s going to do nothing but fantastic things for your osteoarthritis.

It will also make for a smoother experience and recovery if a surgery such as total joint replacement is necessary. 

Q: How does obesity play a role in arthritis?

Losing weight is one of the best things you can do to decrease pain in the musculoskeletal system. There are some patients we advise to lose weight prior to knee surgery, for example. Let’s say you set a goal to lose 30 or 40 pounds but only end up losing 20.

That 20 pounds – even though it is short of your goal – is enough for your knee to feel much better. We may actually be able to take you off the path to surgery because there is less pressure on the knee.

Losing weight is certainly easier said than done, but it can make a big difference.  

Related: Why your weight matters when it comes to hip and knee pain

Q: Are there steps people can take to prevent both arthritis and heart disease?

Be active. One of the things that happens particularly with knees as they get arthritis is that they get stiff and more painful. And the more painful your knee pain gets, the less you want to use it and the stiffer it gets. It’s a cycle that repeats.

Keeping your joints limber really can have an impact on the quality of life you have and the amount of pain you have. It’s a bit of a paradox because when joints get stiff, you want to be less active. But being more active is what is going to add flexibility and alleviate symptoms.

Try these 4 exercises for aching knees.

And as we’ve discussed, being active can also help lower your risk of heart disease.

Q: What advice do you have for people who want to move better but may be starting to deal with arthritis?

Keep moving. That doesn’t mean you need to go out and start running if you’re not a runner. But take up a hobby or activity that is low impact like swimming or cycling. These can help alleviate some of the pain and are also good for your cardiovascular system. Of course, you should consult your doctor before starting any new exercise program.

Ready to move better?

About the Author

Sean Haslam, MD, FRCSC, FAAOS, is an orthopedic specialist on the medical staff at Baylor Scott & White Medical Center – Centennial. He is fellowship-trained in sports medicine and total joint replacement. Dr. Haslam has a keen interest in helping patients with arthritis find relief from pain and a more active life. Get to know Dr. Haslam.

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