Association between osteoarthritis and cardiovascular disease: Systematic review and meta-analysis

Andrew J. Hall, Brendon Stubbs, Mamas A. Mamas, Phyo K. Myint, Toby O. Smith

Research output: Contribution to journalArticlepeer-review

123 Citations (Scopus)
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BACKGROUND: To examine for a possible relationship between osteoarthritis and cardiovascular disease.

DESIGN: A systematic review and meta-analysis.

METHODS: Published and unpublished literature from: MEDLINE, EMBASE, CINAHL, the Cochrane Library, OpenGrey and clinical trial registers. Search to 22 November 2014. Cohort, case-control, randomised and non-randomised controlled trial papers reporting the prevalence of cardiovascular disease in osteoarthritis were included.

RESULTS: Fifteen studies with 32,278,744 individuals were eligible. Pooled prevalence for overall cardiovascular disease pathology in people with osteoarthritis was 38.4% (95% confidence interval (CI): 37.2% to 39.6%). Individuals with osteoarthritis were almost three times as likely to have heart failure (relative risk (RR): 2.80; 95% CI: 2.25 to 3.49) or ischaemic heart disease (RR: 1.78; 95% CI: 1.18 to 2.69) compared with matched non-osteoarthritis cohorts. No significant difference was detected between the two groups for the risk of experiencing myocardial infarction or stroke. There was a three-fold decrease in the risk of experiencing a transient ischaemic attack in the osteoarthritis cohort compared with the non-osteoarthritis group.

CONCLUSIONS: Prevalence of cardiovascular disease in patients with osteoarthritis is significant. There was an observed increased risk of incident heart failure and ischaemic heart disease in people with osteoarthritis compared with matched controls. However, the relationship between osteoarthritis and cardiovascular disease is not straightforward and there is a need to better understand the potential common pathways linking pathophysiological mechanisms.

Original languageEnglish
Pages (from-to)938-946
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Issue number9
Early online date13 Oct 2015
Publication statusPublished - 1 Jun 2016

Bibliographical note

PROSPERO Registration: CRD 42014007021. Peer-reviewers: Ben Drew – NIHR Leeds Musculoskeletal Biomedical Research Unit, University of Leeds (; Dr Chris Fox – Clinical Reader, Norwich Medical School, University of East Anglia ( All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

The authors received no financial support for the research, authorship, and/or publication of this article.


  • osteoarthritis
  • cardiovascular disease
  • cerebrovascular disease
  • myocardial infarction
  • hypertension


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