There is marked underdiagnosis and undertreatment of cardiac risk in rheumatoid arthritis, according to a recent study. Several major barriers exist, including lack of time. Researchers examined 300 patient charts from 10 university-affiliated rheumatology practices, to ascertain if they had been screened, treated, and/or referred over a 3-year period. They subsequently distributed a national survey to rheumatologists to elucidate challenges in performing optimal cardiovascular risk modification. They found:

• Most patients were screened for hypertension.
• 41% were found to be hypertensive; however, the majority of these patients were neither treated nor referred to another provider for management.
• A small minority of patients was screened for diabetes and/or hyperlipidemia, and these were usually not addressed if abnormal.
• Men were referred more frequently than women.
• Consistent with these findings, the majority of rheumatologists from the national survey felt that they did not manage cardiovascular risk adequately; 79.4% cited a lack of time as a major barrier, and 82.5% felt that it should be managed by the primary care provider.