For a study, researchers sought to assess cardiovascular risk in patients with rheumatoid arthritis (RA) who were classified as low-risk by the Framingham score before and after the 1.5-fold multiplication recommended by the European League Against Rheumatism (EULAR) and to stratify them using carotid and femoral Doppler ultrasound (DUS) to optimize the assessment of asymptomatic cardiovascular disease incidence. The study included 35 female patients with RA and 35 healthy women (control group), who had minimal cardiovascular risk based on their Framingham scores (randomized). They were all subjected to carotid and femoral DUS investigations. 

The mean age at diagnosis was 44.57. The mean disease duration was 12.11 years. The mean disease activity score was 1.91 according to the Disease Activity Score 28, but 6.176 according to the Clinical Disease Activity Index. The sample had a uniform distribution. The carotid/or femoral DUS changes were seen in 46% of the RA group vs. 14% in the control group (P=0.004). About 31% of carotid DUS and 81% of femoral DUS had intima-media thickness and/or atherosclerotic plaques (P=0.005). Following the EULAR 1.5 multiplication factor, 66% of the participants still had a low cardiovascular risk. Changes in the carotid and/or femoral DUS were seen in 35% of the patients compared to 14% in the control group (P=0.07). The EULAR criteria were excellent in identifying people at high risk of cardiovascular disease. Therefore, Carotid DUS and, in particular, femoral DUS techniques may be utilized in clinical practice to detect CVD even when the disease is asymptomatic.