Patients with rheumatoid arthritis have an increased risk of cardiovascular disease (CVD). Cardiovascular event rates are markedly increased in rheumatoid arthritis (RA). Data from population- and clinic-based epidemiologic studies of rheumatoid arthritis patients suggest that individuals with rheumatoid arthritis are at risk for developing clinically evident congestive heart failure (CHF). The vasculature plays a crucial role in inflammation, angiogenesis, and atherosclerosis associated with the pathogenesis of inflammatory rheumatic diseases. There is overwhelming evidence that, in the general population and several at risk subpopulations, exercise provides significant physical and psychosocial benefits, and facilitates management and improvements of outcome in Rheumatic disease. There is increased recognition of the need for structured preventive strategies to reduce the risk of CVD in patients with RA. In this review, the research agenda for understanding and preventing CVD comorbidity in patients with rheumatoid arthritis is discussed.