When you have rheumatoid arthritis (RA) it's understandable that you would be more concerned with controlling pain and inflammation. However, you should also be aware of the strong link between heart disease and rheumatoid arthritis.

If you have RA, you're more likely to develop coronary heart disease, suffer unrecognized heart attacks and sudden cardiac death, according to the Mayo Clinic. The heart disease risk may exist even before you're diagnosed with rheumatoid arthritis. According to the researchers, in the two years before patients were diagnosed with rheumatoid arthritis, they were three times more likely to have been hospitalized for an acute heart attack and five times more likely to have an unrecognized heart attack.

Traditional risk factors such as age and hypertension contribute to rheumatoid arthritis and increased cardiovascular disease risk. However, symptoms specific to rheumatoid arthritis are also implicated such as inflammation, including neutrophil count, radiographic score and uric acid levels.

The medical community is calling for more awareness of the connection between rheumatoid arthritis and cardiovascular disease. Once you have cardiovascular disease, it significantly impacts your quality of life and cuts your life expectancy. Although there are few guidelines for preventing heart disease when you have rheumatoid arthritis, following these general pointers to reduce CVD risk can make a difference.

• Control inflammation. The inflammation caused by rheumatoid arthritis that contributes to atherosclerosis, or the buildup of plaque in your arteries. When the arteries become clogged, clots form and you can suffer a heart attack or stroke.

• Cut your fat intake. Avoid using products containing trans, hydrogenated or saturated fat, such as margarine, shortening, butter, and processed or packaged foods. Use healthy oils such as olive oil, especially extra virgin olive oil, almond oil, and sesame oil.

• Eat fatty fish. Research shows that fish high in omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), provide several heart benefits. According to the American Heart Association (AHA), omega-3 fatty acids decreased triglyceride levels and growth rate of atherosclerotic plaque, decresed the risk of arrhythmias, which lead to sudden cardiac death and slightly lowered high blood pressure.

The AHA recommends eating fatty fish such as albacore tuna, herring, trout or salmon at least twice a week. Soybeans, canola, walnuts and flaxseeds contain alpha-linolenic acid which breaks converts into omega-3 fatty acids in your body. You can also take EPA and DHA in capsule form under medical supervision.

• Exercise regularly. Physical activity relieves inflammation and other symptoms of rheumatoid arthritis - and boosts cardiovascular health. Just 30 minutes of exercise a day, five days a week, can lower hypertension and cholesterol levels when you have RA, states the Arthritis Foundation.

Stick to (or increase) your therapeutic exercises. Also, add aerobic, strength-training, and meditative exercises to your routine. Always get advice from your rheumatologist and physical therapist before starting an exercise plan.

• Quit smoking. Cigarette smoking is one of the leading causes of heart disease. It increases blood pressure and the tendency for blood to clot, and decreases good cholesterol and exercise, states the AHA. It's one of the major factors in atherosclerosis or the buildup of fatty tissue in the arteries. Studies also show that cigarette smoking increases levels of inflammatory markers, such as C-reactive protein and white blood cell count. The inflammation-causing substances contribute to atherosclerosis as well.

• Cut out salt. High sodium intake increases your blood pressure, which increases the risk of heart disease. The AHA advises most people to eat less than 2,300 mg of salt per day. However, if you are African American, middle-aged or older, or already have high blood pressure, aim for less than 1,500 mg per day. Most prepared foods contain high sodium levels, so be sure to read labels. Also, use spices when you're cooking for flavor, instead of salt.