An arthritis flare, unexpected changes at home or work, even the start of a new year can create stress and anxiety. These emotions lead to depression in some people –including many who have arthritis. A 2012 study by the Centers for Disease Control and Prevention found that one-third of people with arthritis also have depression or anxiety.
The pressure of coping with arthritis can ratchet up stress and anxiety – a condition that affects as many as 1 in 3 people with arthritis. And that, in turn, can worsen the symptoms of chronic diseases and contribute to a host of other problems.
“When we are stressed or perceive a threat, our body responds with physiologic responses that prepare us to fight or escape the enemy,” says Rudy Nydegger, PhD, a clinical psychologist and professor emeritus at Union Graduate College in Schenectady, N.Y. “Our heart rate and breathing speed up, our muscles tense and blood flow to the brain increases, putting us in a state of high awareness.” That can help protect you if the enemy is an attacking tiger and the threat ends quickly. But when ongoing stress leads to anxiety (excessive worry), it can result in a heightened awareness of symptoms – for instance, pain feels worse – as well as increased susceptibility to infection and risk of other health problems, including heart disease. Anxiety can have indirect health impacts, too, if it leads to inactivity, interferes with sleep or leads you to eat unhealthy foods for comfort.
Replacing damaged joints gives people with arthritis a dramatically improved quality of life – with reduction or even elimination of pain and improved mobility. A new joint can give you a new lease on life, allowing you to resume activities you love and improve your mood and relationships. But like anything in life, there are risks and benefits. A group of studies about the effects of joint replacement on your heart demonstrate those risks and benefits.
Studies published in recent years, suggested that certain people are at increased risk of heart trouble following joint surgery. For example, a study in Annals of the Rheumatic Diseases in 2011 found an increased risk for cardiac complications following joint replacement surgery in older patients and in those who had pre-existing heart disease, deep vein thrombosis or pulmonary embolism. And a 2012 study published in Archives of Internal Medicine found that hip and knee replacement surgery boosts the risk of heart attack during the first two weeks after surgery, particularly in patients older than 60.
People with autoimmune disease such as lupus and rheumatoid arthritis (RA) are more likely to get dangerous blood clots during hospital stays. In fact, one 2014 Arthritis Research & Therapy meta-analysis of 25 studies found that people with inflammatory rheumatic diseases were three times more likely to experience venous thromboembolisms (VTEs, or blood clots in the veins) than the general population.
Lupus patients are four times more likely than people without an autoimmune disease to develop blood clots when hospitalized. And RA patients are one-and-a-half times more likely to develop blood clots during a hospital stay. According to a 2011 study from researchers in the United Kingdom, anyone with an immune-related disorder faces some sort of increased risk.