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===Heart and blood vessels=== People with RA are more prone to [[atherosclerosis]], and risk of [[myocardial infarction]] (heart attack) and [[stroke]] is markedly increased.<ref>{{cite journal | vauthors = Wolfe F, Mitchell DM, Sibley JT, Fries JF, Bloch DA, Williams CA, Spitz PW, Haga M, Kleinheksel SM, Cathey MA | title = The mortality of rheumatoid arthritis | journal = Arthritis and Rheumatism | volume = 37 | issue = 4 | pages = 481β494 | date = April 1994 | pmid = 8147925 | doi = 10.1002/art.1780370408 | doi-access = free }}</ref><ref>{{cite journal | vauthors = AviΓ±a-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D | title = Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies | journal = Arthritis and Rheumatism | volume = 59 | issue = 12 | pages = 1690β1697 | date = December 2008 | pmid = 19035419 | doi = 10.1002/art.24092 }}</ref><ref>{{cite journal | vauthors = Alenghat FJ | title = The Prevalence of Atherosclerosis in Those with Inflammatory Connective Tissue Disease by Race, Age, and Traditional Risk Factors | journal = Scientific Reports | volume = 6 | pages = 20303 | date = February 2016 | pmid = 26842423 | pmc = 4740809 | doi = 10.1038/srep20303 | bibcode = 2016NatSR...620303A }}</ref> Other possible complications that may arise include: [[pericarditis]], [[endocarditis]], left ventricular failure, valvulitis and [[fibrosis]].<ref name="Gupta">{{cite journal |vauthors=Gupta A, Fomberstein B |title=Evaluating cardiovascular risk in rheumatoid arthritis |journal=Journal of Musculoskeletal Medicine |volume=26 |issue=8 |pages=481β494 |year=2009 |url=http://www.musculoskeletalnetwork.com/rheumatoid-arthritis/content/article/1145622/1433094 |url-status=live |archive-url=https://web.archive.org/web/20120723164920/http://www.musculoskeletalnetwork.com/rheumatoid-arthritis/content/article/1145622/1433094 |archive-date=2012-07-23 }}</ref> Many people with RA do not experience the same chest pain that others feel when they have angina or myocardial infarction. To reduce cardiovascular risk, it is crucial to maintain optimal control of the [[inflammation]] caused by RA (which may be involved in causing the cardiovascular risk), and to use exercise and medications appropriately to reduce other cardiovascular risk factors such as blood lipids and blood pressure. Doctors who treat people with RA should be sensitive to cardiovascular risk when prescribing anti-inflammatory medications, and may want to consider prescribing routine use of low doses of aspirin if the gastrointestinal effects are tolerable.<ref name="Gupta"/>
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