was not fully explained by the model used in this study, and in view of previous findings [43] it is an important limitation that patient education, health literacy, and patient-physician communication were not assessed in this study. Finally, several factors may limit the generalizability of the findings of this study, such as the site at an academic referral center with substantial clinical subspecialization, as well as the racial and ethnic homogeneity of the study population. The contribution of this study is a comprehensive, patient-level description of the clinical phenotypes that are associated with patient-provider discordance. This study should inform the selection and testing of patient-reported outcomes for routine evaluation of discordance. The findings should inform the development of a standardized approach to evaluation and management, as well as enhancement of patient-provider communication and shared decision making for RA patients in the scenario of discordance. At this time, it would be prudent for rheumatology care providers to diagnose and treat comorbidities, such as depression and fibromyalgia, using available pharmacologic and nonpharmacologic therapies and to monitor the impact on the health status of patients. Rheumatoid arthritis, which affects up to three times as many women as men, according to an article published in September 2017 in the journal Rheumatology International, can also cause non-joint-specific symptoms, including fever, weight loss, and fatigue.right up arrow Left untreated, RA can lead to a number of complications or comorbidities (co-occurring conditions) throughout the body, notes the Centers for Disease Control and Prevention (CDC).right up arrow These complications and conditions may be more fatal to people with RA than those without. In fact, people with RA are nearly twice as likely to succumb to health problems like cancer and heart and respiratory conditions before age 75 than those without the disease, according to a study published in March 2018 in the journal Arthritis Care and Research.right up arrow Rheumatoid Arthritis and Heart Disease Risk People with RA often suffer from one or more additional conditions. Some of these comorbid conditions may be unrelated to RA, like certain cancers, but in other cases they may be directly or indirectly caused by RA, RA treatment, or RA outcomes — such as decreased mobility and functional impairment, for example. The most common and well-documented RA comorbidity is cardiovascular disease, in particular ischemic heart disease, in which there's a reduced blood supply in the heart. People with heart disease are nearly twice as likely to also have RA compared with those who don't have heart issues, according to the CDC.right up arrow Rheumatoid arthritis is also associated with several specific cardiovascular issues, including heart attack, stroke, congestive heart failure, peripheral vascular disease, and atrial fibrillation.right up arrow Research published in March 2015 in the journal Nature Reviews Rheumatology found that people with RA are more likely to have atherosclerosis (buildup of fat, cholesterol, and plaque on blood vessel walls), and they develop it at a faster rate than the general population.right up arrow People with preclinical RA (a precursor condition to RA) aren't safe from heart issues either. One study found that people with preclinical RA have a 24 percent increased risk of having a cardiovascular event over a 10-year