Vascular Function and Inflammation in Rheumatoid Arthritis: the Role of Physical Activity

George S. Metsios1, 2, *, Antonios Stavropoulos Kalinoglou1, 2, Aamer Sandoo2, Jet J.C.S. Veldhuijzen van Zanten2, Tracey E. Toms2, Holly John2, George D. Kitas2
1 School of Sport Performing Arts and Leisure, University of Wolverhampton, Walsall, West Midlands, United Kingdom
2 Department of Rheumatology, Dudley Group of Hospitals NHS, Foundation Trust, Russell’s Hall Hospital, Dudley, West Midlands, United Kingdom

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© Metsios et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the School of Sport Performing Arts and Leisure, University of Wolverhampton, Wolverhampton, West Midlands, United Kingdom; Tel: +44-0121-4561302; E-mail:


Inflammation disturbs biochemical pathways involved in homeostasis of the endothelium. Research has established clear links between inflammatory mediators, particularly C-reactive protein and tumour necrosis factor alpha, endothelial dysfunction, and atherosclerosis. Endothelial dysfunction and atherosclerosis may be subclinical at early stages, and thus the ability to detect them with non-invasive techniques is crucially important, particularly in populations at increased risk for cardiovascular disease, such as those with rheumatoid arthritis. This may allow the identification of interventions that may reverse these processes early on. One of the best non-pharmacological interventions that may achieve this is physical activity. This review explores the associations between inflammation, endothelial dysfunction, and atherosclerosis and discusses the role of exercise in blocking specific pathways in the inflammation, endothelial dysfunction - atherosclerosis network.

Keywords: Inflammation, Atherosclerosis, Endothelial function, Cytokines, Vascular function, Exercise, Physical activity, Cardiovascular disease..