The medications you count on to soothe the painful, swollen joints may also affect your heart. That’s of special concern if you live with rheumatoid arthritis (RA), because research has shown that the chronic inflammation that is the hallmark of the disease can double your risk of a heart attack.

Here is what experts have to say on some of the most common arthritis drugs and your risks for heart attacks, heart failure and stroke.

DMARDs

Most traditional disease-modifying anti-rheumatic drugs (DMARDs) appear to lower the risk of heart attacks and strokes, says Martin Jan Bergman, MD, chief of rheumatology at Taylor Hospital in Ridley Park, Pa.

“The longer you take them, the lower the risk,” says Dr. Bergman, who is analyzing data from the Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) program. His latest results show that taking methotrexate for just one year decreased risk of heart attack by 18 percent and decreased risk for stroke by 11 percent.

The DMARDs sulfasalazine (Azulfidine) and leflunomide (Arava) had similar effects, Dr. Bergman says, while gold sodium thiomalate (Myochrysine) and antimalarials like hydroxychloroquine (Plaquenil), seemed to have little impact on cardiovascular risks.

TNF blockers

Biologic drugs that block a chemical signal that spurs inflammation, called tumor necrosis factor alpha blockers, or TNF- a blockers, have revolutionized the treatment of RA. The data on how they affect the heart, however, is murky.

While research showed a decrease in risk of cardiovascular disease and heart attacks among people with RA who took TNF blockers, heart failure appears to be another story.

People with heart failure have high levels of TNF-a, so it was initially thought that TNF-a blocker drugs might be a treatment for this condition, says Daniel H. Solomon, MD, chief of clinical sciences in the division of rheumatology at Brigham and Women’s Hospital in Boston.