AIMS: To assess differences in estimated cardiovascular disease (CVD) risk among rheumatoid arthritis (RA) patients from different world regions and to evaluate the management and goal attainment of lipids and blood pressure (BP). METHODS AND RESULTS: The survey of CVD risk factors in patients with RA was conducted in 14 503 patients from 19 countries during 2014-19. The treatment goal for BP was <140/90 mmHg. CVD risk prediction and lipid goals were according to the 2016 European guidelines. Overall, 21% had a very high estimated risk of CVD, ranging from 5% in Mexico, 15% in Asia, 19% in Northern Europe, to 31% in Central and Eastern Europe and 30% in North America. Of the 52% with indication for lipid-lowering treatment (LLT), 44% were using LLT. The lipid goal attainment was 45% and 18% in the high and very high risk groups, respectively. Use of statins in monotherapy was 24%, while 1% used statins in combination with other LLT. Sixty-two per cent had hypertension and approximately half of these patients were at BP goal. The majority of the patients used antihypertensive treatment in monotherapy (24%), while 10% and 5% as a two- or three-drug combination. CONCLUSION: We revealed considerable geographical differences in estimated CVD risk and preventive treatment. Low goal attainment for LLT was observed, and only half the patients obtained BP goal. Despite a high focus on the increased CVD risk in RA patients over the last decade, there is still substantial potential for improvement in CVD preventive measures.

1st Medical Faculty Charles University Prague Czech Republic

3rd Department of Internal Medicine Department of Endocrinology and Metabolism 1st Medical Faculty Charles University and General Faculty Hospital Prague Czech Republic

5 A Nasonova Research Institute of Rheumatology Moscow Russia

Bernhoven Hospital Uden the Netherlands

Center of Cardiology of Russian Ministry of Healthcare Moscow Russia

Department of Clinical Immunology and Rheumatology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow Uttar Pradesh India

Department of Internal Medicine University of Manitoba Winnipeg Manitoba Canada

Department of Medicine Division of Rheumatology University of Toronto Toronto Ontario Canada

Department of Rheumatology and Immunology Peking University People's Hospital Beijing 100044 China

Division of Biomedical Statistics and Informatics Department of Health Sciences Research Mayo Clinic Rochester MN USA

Division of Rheumatology 2nd Department of Internal Medicine Gastroenterology Charles University Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové Hradec Králové Czech Republic

Division of Rheumatology Department of Internal Medicine Mayo Clinic Rochester MN USA

Dudley Group NHS Foundation Trust Dudley West Midlands UK

Hospital Universitario 'Dr José E González' UANL Monterrey México

Hospital Universitario Marqués de Valdecilla Santander Spain

Iii Interna klinika fn Olomouc Olomouc Czech Republic

Institute of Rheumatology Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán México City México

Ivanovo State Medical Academy Ivanovo Russia

Joint Rheumatology Program 1st Department of Propaedeutic Internal Medicine Laiko Hospital School of Medicine National and Kapodistrian University of Athens Athens Greece

Joint Rheumatology Program 2nd Department of Medicine and Laboratory Hippokration General Hospital National and Kapodistrian University of Athens Athens Greece

Kyrgyz State Medical Academy Bishkek Kyrgyz Republic

Mater Dei Msida Malta

National Institute of Rheumatic Diseases 92101 Piešťany Slovensko Slovakia

Preventive Cardio Rheuma Clinic Division of Rheumatology and Research Diakonhjemmet Hospital Diakonveien 12 0370 Oslo Norway

Rheumatology Department Cliniques Universitaires Saint Luc Institut de recherche expérimentale et clinique Université catholique de Louvain Brussels Belgium

Spedali Civili and University of Brescia Brescia Italy

Swedish Rheumatoid Arthritis Registry Umeå Sweden

Tallagh University Hospital Dublin Ireland

The Lundquist Institute Harbor UCLA Medical Center Torrance CA USA

Trinity College Dublin Dublin Ireland

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