Rheumatoid Arthritis and Life Expectancy
Rheumatic ConditionsRheumatoid Arthritis

How Rheumatoid Arthritis Affects Life Expectancy

How Rheumatoid Arthritis Affects Life Expectancy
Everyday Health
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Published on March 17, 2026
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Rheumatoid arthritis (RA) is a chronic autoimmune disorder whose hallmark symptom is inflammation in the joints resulting in swelling, pain, and stiffness.

But RA, particularly if left untreated or undertreated, can also cause inflammation in other parts of the body, including the blood vessels, heart, and lungs, potentially leading to cardiovascular disease, lung disease, and other systemic diseases.

These complications, along with some commonly occurring comorbidities such as depression, are largely responsible for the shortened life expectancy associated with rheumatoid arthritis.

But with the advent of newer, biologic medications for RA, people with RA appear to be living longer.

“Severe, active, and untreated RA can reduce life expectancy by as much as 6 to 10 years,” says Douglas White, MD, PhD, a rheumatologist with Articularis Rheumatology Specialists in Sandy Springs, Georgia. “But life expectancy is much improved (often to normal) with modern RA therapy and good disease control.”

Learn how RA could be shortening your lifespan and what you can do to live a longer, healthier life.

How RA Shortens Lifespan

Complications and comorbidities of RA are the main contributors to a shorter life expectancy, although in some cases, the medications used to treat RA can contribute as well.

Cardiovascular Disease

RA increases your risk of cardiovascular disease. “While RA patients do not die from joint disease, their life expectancy is typically impacted due to an unexpected increased risk of cardiovascular disease (CAD) and heart attacks,” says Andrew Holman, MD, the CEO and cofounder of Inmedix, a medical diagnostics company in Normandy Park, Washington.

“RA patients also have higher daily sympathetic activity, also known as the “fight or flight” response, compared to those without RA. High activity levels of adrenaline are also considered an independent risk factor for CAD,” says Dr. Holman.

Cardiovascular manifestations of RA include accelerated atherosclerosis (narrowing and stiffening of the arteries), heart failure, pericarditis (inflammation of the sac that surrounds the heart), myocarditis (inflammation of the middle layer of the heart’s wall), and endocarditis (infection of the inner lining of the heart chambers and valves).

People with RA are also more likely to have heart disease risk factors, including:

  • High blood pressure
  • Obesity
  • Metabolic syndrome, which is the combination of high blood pressure, high blood glucose, high triglycerides and LDL cholesterol, and obesity
  • Abnormal lipid levels in the blood
  • Smoking

Lung Disease

People living with RA have an eight times higher chance of developing lung disease than the general population, with 1 in 10 people with RA developing a condition known as interstitial lung disease (ILD).

ILD is a collection of disorders associated with inflammation and scarring of the lung’s tissue and is one of the more serious complications associated with RA. It occurs when the overactive immune system starts to attack your lungs, leading to a buildup of scarring.

As the scarring increases, it can make it more difficult to breathe. In some cases, you may need a lung transplant to restore function in the lungs.

One study found that pulmonary complications are directly responsible for 10 to 20 percent of RA deaths.

 And another study found a strong association between RA-ILD and excess mortality, in particular respiratory and cancer mortality.

Researchers note that people with RA-ILD have a high risk of serious infection, especially respiratory infection, and that in this population, infection develops early, is recurrent, and is frequently fatal.

Infection

People with RA are more susceptible to infection, because of the autoimmune nature of the disease and the use of immunosuppressing or immunomodulating medications like glucocorticoids, biologics, and disease-modifying antirheumatic drugs (DMARDs).

Because the immune system is compromised, infectious disease can become serious enough to be fatal. One study found that people with RA have 2.2 times the risk of death due to infection compared with people without the condition.

Research has also found that the majority of serious infections in RA patients are caused by bacterial infections.

 But viral infections, such as herpes zoster (shingles), hepatitis B, and tuberculosis may be more likely to occur or be reactivated in people with RA, and while rare, fungal infections can also be fatal.

Depression

Depression is a commonly occurring comorbidity associated with RA. The rate of depression in people with RA is two to three times higher than in the general population.

 Researchers think that affective distress (like depression and anxiety) and RA may have a bidirectional relationship, each influencing the other; depression may partly be due to RA-related inflammation and, in turn, depression can worsen RA symptoms, altering pain perception.

Depression can be a factor in reducing life expectancy. While the research results need to be taken with caution, studies have shown that patients with RA who have comorbid depression have higher risk of mortality than non-depressed patients.

A large-scale meta-analysis of 268 studies found a twofold increased mortality risk in people with depression compared with control subjects; people with depression displayed 1.6-fold elevated risk of mortality from natural causes as well as a 9.9‐fold increased risk of suicide compared with people without depression. (Note: This meta-analysis involved people with depression, not necessarily RA.)

Cancer

RA puts a person at a slightly elevated risk of developing certain cancers. An Australian study of more than 14,000 people with RA found that while the overall incidence of cancer was actually lower in people with RA than those without, certain types of cancer had higher incidence rates in people with RA, including lung and blood cancers such as lymphoma. The study also found that overall survival rates were lower for patients with RA than control subjects, with increased mortality rates observed for most cancer subtypes.

Over the years, researchers have considered the use of biologics as a possible cause. But growing evidence suggests that RA increases the risk of cancer directly because of chronic inflammation.

Still, the increased risk of cancer remains relatively low for people with RA. For non-Hodgkin lymphoma, the most common type, the risk increases from 2 percent to 4 percent. While the increased risk is there and should be considered, the Arthritis Foundation describes it as modest.

How to Help to Lengthen Your Life With RA

Modern improvements in medications to treat RA have helped to increase life expectancy greatly in recent years.

To increase your longevity, you can take some of the following steps.

Effective RA Treatments

One of the most effective ways to increase your life expectancy when living with RA is to follow your treatment team’s recommendations. The main goals of treatment involve slowing disease progression and reducing inflammation.

Treatment with DMARDs, which reduce inflammation, is one of the best ways to help lower your risk of heart related issues, including heart attack or stroke.

Medications can also reduce your risk of comorbidities, though some, like biologics and steroids, can increase your risk of complications. Biologics, because they are immunosuppressive, increase your risk of infections.

 Your treatment team should monitor you for signs of infections due to taking your RA medications. Both White and Holman indicate a need to monitor and limit corticosteroid use. This is because of concerns about toxicity as well as the increased risk of infection with their use.

Dr. White also recommends lifestyle, diet, and exercise interventions to minimize risk of CAD.

Preventive Measures

Proactively keeping on top of your RA treatment is the best way to prevent complications.

 You should see your treatment team regularly and let your team know if you have any new or worsening symptoms, even if these symptoms don’t seem directly related to your joints.
Also make sure you’re up-to-date on your vaccinations to reduce your risk of developing an infection. Get the recommended vaccinations for influenza, shingles, and pneumococcal pneumonia to reduce your risk of potentially serious consequences.

 Discuss which vaccinations you need and when to get them with your healthcare team.

Caring for Your Mental Health

The impact that RA can have on mental health is significant, and the relationship between mental health, RA, and life expectancy is complex.

It’s important to seek help if you’re experiencing mood symptoms. Talk with your doctor, who can recommend treatment, possibly in the form of psychotherapy, support groups, or medication.

“I encourage strong social networks and mental health care for all patients with chronic illnesses, including RA,” says White.

Taking steps to manage stress can help. Holman suggests the following:

  • Prioritize sleep.
  • Practice mindfulness.
  • Address other underlying issues, such as sleep apnea.

The Takeaway

  • The complications and comorbidities associated with RA can shorten lifespan; the inflammation of RA is thought to increase your risk of certain conditions which may be fatal, including cardiovascular and lung diseases.
  • By improving RA outcomes, modern medications and treatments have helped significantly increase life expectancy.
  • Work with your medical team to optimize your RA treatment and make some lifestyle changes to improve your longevity.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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Samir Dalvi, MD

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Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, and gout.

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