Rheumatoid arthritis (RA) is a systemic autoimmune disease that is characterized by chronic inflammatory lesions of synovial joints and involves the heart, lungs, nerves, blood and other organs and tissues. Compared to the general population, patients with RA have a higher risk of cardiovascular disease, CVD, morbidity and mortality. The increased risk cannot be fully explained by traditional cardiovascular risk factors, although they do play a part in it. The exact mechanism by which RA leads to CVD is still unclear. inflammation is the most important factor linking RA to CVD throughout the process of atherosclerosis and reinforces the role of some of the traditional risk factors. management of RA cardiovascular risk should be mandatory, so what are the common management measures currently used? I. Adequate control of RA disease The role of systemic inflammation in the development of RA is crucial; therefore, control of the primary disease is a prerequisite for reducing the incidence of CVD. Studies have demonstrated that early and effective antirheumatic therapy is independently associated with lower cardiovascular risk. The drugs with the most current evidence are methotrexate and TNF-α blockers. Methotrexate can cause hyperhomocysteinemia and therefore requires concomitant folic acid supplementation. The cardiovascular risks of NSAIDs remain to be further investigated, and guidelines recommend that clinicians remain cautious when using these drugs in RA patients who also have a combination of cardiovascular risk factors or who already have CVD. Naproxen has the highest cardiovascular safety profile and is recommended as a first choice when it is essential, with regular monitoring of blood pressure and renal function. Glucocorticoids have a negative impact on certain cardiovascular risk factors, but have strong anti-inflammatory and anti-atherosclerotic effects, and their effect on cardiovascular risk in RA is unclear. Second, adjust the lifestyle of RA patients to adjust their lifestyles mainly include three aspects. First, encourage and instruct patients to quit smoking. Smoking not only plays an important role in the pathogenesis of RA, but also is associated with higher disease activity and poor prognosis; therefore, quitting smoking can benefit the RA population even more. Second, physical activity. Exercise can prevent CVD and its risk factors, even including inflammation, and encouraging physical activity in RA patients can effectively prevent cardiovascular events. Third, the Mediterranean diet. Mediterranean diet is rich in omega-3 unsaturated fatty acids, and studies have shown that omega-3 unsaturated fatty acids can not only reduce cardiovascular risk, but also reduce chronic inflammation in RA patients. Third, drug therapy 1, lipid-regulating drugs: a recent study showed that patients with inflammatory arthritis receiving statin therapy can reduce LDL-C levels and cardiovascular risk, and the benefit of primary prevention depends on age and other risk factors. It remains uncertain when prophylactic lipid-modifying therapy should be initiated in RA patients, and guidelines recommend that RA patients, like diabetic patients, should have early intensive lipid-modifying therapy to achieve LDL-C <, 5 mmol/L. A study by Ridker et al. found a reduced incidence of major adverse cardiovascular events and increased high-sensitivity C-reactive protein levels after oral statins were given to healthy individuals, suggesting that statins, in addition to their The anti-inflammatory effects of statins play an important role in cardioprotection, in addition to their lipid-modulating effects. It was hypothesized that the cardioprotective effect of statins might be better in this specific population of RA. However, a recently published observational study found that statins were less effective than other populations in patients with chronic diseases, including RA. Therefore, more randomized controlled trials are needed to assess the true effects of statins. Despite the lack of data from prospective studies, guidelines recommend that patients with RA should have strict control of systolic blood pressure <140 mm Hg. There are few data on the preferred antihypertensive drugs for patients with RA, but some evidence supports that angiotensin-converting enzyme inhibitors can benefit patients with RA. The endothelial function of RA patients was improved and CD40 levels were reduced after 8 weeks of treatment with angiotensin converting enzyme inhibitors. 3. Antiplatelet agents: Despite the increased incidence of arteriovenous thrombosis in RA patients, there are no studies of RA patients using antiplatelet therapy to reduce cardiovascular risk. The combination of aspirin with other NSAIDs is generally not recommended because it may reduce the antiplatelet effect of aspirin. Further studies are needed to confirm the effectiveness and safety of antiplatelet therapy. In conclusion, patients with RA are susceptible to CVD, and in this population, strict control of the primary disease and cardiovascular risk factors is necessary. Appropriate cardiovascular risk management requires a joint effort between rheumatologists or cardiologists and patients. During the clinical consultation, rheumatologists and cardiologists need to fully understand the risk of RA combined with CVD, and reasonably select and adjust medications in order to effectively treat RA and reduce the occurrence of CVD. Patients should actively cooperate with smoking cessation, adhere to physical exercise, reasonable diet, and regular cardiovascular risk assessment.