← Questions/BEYOND THE SPINE
Does AS affect my heart or circulation?
The short answer
Long-running inflammation raises cardiovascular risk, and recent large studies add two specifics: people with AS had a 40 percent higher rate of peripheral artery disease, most marked in women under 60, and those who have had a blood clot are far more likely than non-inflammatory patients to have another. Neither is a reason for alarm; both are reasons for the usual checks on blood pressure, cholesterol and circulation to actually happen.
3 papers behind this answer, best first
Clicking through to a study? How to read a paper is the ten-minute version.
Risk of peripheral artery disease following ankylosing spondylitis, 2012–2023: a nationwide cohort study in South Korea
Scandinavian Journal of Rheumatology
Following 2,846 people with ankylosing spondylitis and ten times as many matched controls in South Korea for four years, AS was linked to a 40 percent higher rate of peripheral artery disease, with the largest excess in women under 60. Circulation in the legs is another thing to keep an eye on, especially for younger women with AS.
Clinical Outcomes of Venous Thromboembolism in Patients with Ankylosing Spondylitis vs. Other Immune-mediated Inflammatory Diseases: Insights from the RIETE Registry.
Thrombosis and haemostasis
In a registry of over 112,000 people treated for blood clots, those with ankylosing spondylitis had similar death and bleeding rates to people with other inflammatory diseases, but were seven times more likely than non-inflammatory patients to have a second clot, and those who stopped blood thinners before a year did worse. If you have AS and have had a clot, longer anticoagulation may be warranted; it is worth raising with whoever manages it.
Cardiovascular and Thromboembolic Risk With Upadacitinib in Spondyloarthritis and Inflammatory Bowel Disease: A Meta-Analysis of Randomized Controlled Trials.
Journal of cardiovascular pharmacology
Pooling eight randomised trials of 4,433 people with spondyloarthritis or inflammatory bowel disease, upadacitinib (Rinvoq) showed no increase in heart attacks, strokes or blood clots compared with placebo, though events were rare enough that the result cannot rule out a small risk. The signal that led to warnings on JAK drugs came from older rheumatoid arthritis patients; in this population, the trials so far are reassuring but not conclusive.
Plain-language guides on this from patient organisations
Reviewed sources written for patients. They cover the “what do I do” part that research papers can’t.
- NHS: Complications of AS ↗
NHS (UK)