Arthritis patients should take extra steps to maintain a healthy heart.

According to a study released in the December 2013 issue of Arthritis Care & Research and featured in the Wiley Online Library, osteoarthritis is linked to various forms of heart disease, making arthritis another risk factor to consider in cardiovascular issues. The following four tips could benefit anyone trying to maintain a healthy heart, but may be especially helpful for arthritis patients hoping to avoid heart disease:

1. Stay physically active

As a person living with arthritis symptoms, staying physically active could be painful or even impossible at times. But doing your best to maintain an active lifestyle can help keep your heart healthy and strong. Further, according to the Mayo Clinic, exercise has a positive effect on arthritis pain and helps keep your joints moving.

To keep both your heart and bones as healthy as possible, find exercises that cause you little or no pain. Yoga, water exercises, walking and cycling are all beneficial exercises that will increase your heart rate without adding too much strain or impact to your joints.

2. Maintain a healthy weight

According to the Johns Hopkins Arthritis Center, obesity is a risk factor for both men and women with arthritis. Additionally, having too much body fat makes your heart work harder and may increase your risk of developing heart disease. As an arthritis patient, it is important to maintain a healthy weight by staying physically active and eating a healthy diet. If you are overweight, consult with your doctor to develop a healthy weight loss plan and set goals that are realistic for your specific needs and abilities.

3. Manage stress

Managing chronic pain may be stressful for arthritis patients. According to the Arthritis Foundation, a survey conducted by the Centers for Disease Control and Prevention found that among respondents with arthritis or a related condition, 31 percent had anxiety and 18 percent suffered from depression.

Stress and anxiety are harmful to your overall well-being and may add extra strain on your heart. While many people deal with stress in negative ways, such as eating junk food and smoking, it is important to find healthy ways to cope with stress. Yoga, meditation, counseling, journaling, and having a positive outlook may all help reduce your stress levels.

4. Seek alternative pain relief

Arthritis patients often turn to nonsteroidal anti-inflammatory drugs such as Advil, Motrin and Aleve to relieve arthritis pain. According to the Arthritis Foundation, a study published by the British Medical Journal in 2011 showed that patients who use NSAIDs may be at greater risk of cardiovascular events, including heart attack and stroke. This study showed a link between arthritis and cardiovascular problems, but did not prove cause and effect.

It would be unreasonable to suggest that arthritis patients stop using NSAIDs entirely; however, supplementing your NSAID use with alternative approaches to pain management may help reduce your risk of heart disease. Certain supplements, foods, exercises and Eastern medicinal approaches may all help to ease your arthritic pain. Ask your doctor about NSAID use, and which alternative approaches are appropriate for you.

For more on arthritis:

Flu Vaccine: A Matter of Life or Death?
The Best and Worst Foods for People with Arthritis
The Link: Soft Drinks, Men and Progression of Osteoarthritis