To ask the Secretary of State for Health (1) what the additional risks of (a) heart attacks, (b) strokes and (c) peripheral gangrene are for people suffering from rheumatoid arthritis; (2) what proportion of rheumatoid arthritis patients he estimates will develop accelerated atheroma formation in their arteries as a result of their rheumatoid arthritis condition; (3) what proportion of patients with rheumatoid arthritis he estimates would benefit from anti-TNF therapy. 
All patients with rheumatoid arthritis have an increased risk of developing atheroma, a pathological process that may lead to an increased incidence of coronary heart disease, cerebrovascular disease and peripheral blood vessel disease. The exact mechanism of atheroma formation in rheumatoid arthritis is unclear, but may be associated with the vasculitis observed in rheumatoid arthritis. Peripheral gangrene may result from atheroma in peripheral blood vessels, and sometimes from vasculitis itself. On average, life expectancy is reduced in rheumatoid arthritis by about five years and atheroma is a key contributing cause.In March 2002, the National Institute for Clinical Excellence recommended the use of Etanercept and Infliximab for rheumatoid arthritis. Rheumatoid arthritis affects all ages and ethnic groups and up to 1 per cent. of the population may be affected by it. We expect that about 15,000 people will benefit from anti-TNF therapy.