If you have coronary artery disease (CAD), you are at increased risk of heart attack. If you have CAD and rheumatoid arthritis (RA), your risk is even greater. RA itself is a major risk factor for heart attack, as well as hypertension, high blood lipid levels and heart failure. The reason is only recently understood. "New data confirms that the majority of patients with RA die from ischemic heart disease, and that inflammation is the common denominator in these two diseases," says rheumatologist M. Elaine Husni, M.D., MPH, Vice Chair of the Cleveland Clinics Arthritis and Musculoskeletal Treatment Center.Patients with RA are six times more likely to have a silent heart attack, three times more likely to be hospitalized with an acute heart attack, twice as likely to develop heart failure and almost seven times more likely to die from sudden cardiac death than the general population.