ARTERIAL HYPERTENSION IN RHEUMATOID ARTHRITIS

Аннотация

ABSTRACT 
The aim is to assess the prevalence and risk factors of arterial hypertension (AH) 
in young and middle–aged rheumatoid arthritis (RA) patients. 
Material  and  methods.  222  RA  patients  (34%  with  early  RA)  without 
concomitant  cardiovascular  diseases  were  examined.  The  average  age  was  47±9.7 
years; men were 15%; 60% of patients were seropositive for rheumatoid factor (RF), 
the  average  value  of  DAS  28  was  5.77±1.1,  HAQ-DI  was  1.58±0.7.  Associations 
between risk factors and hypertension were analyzed using logistic regression models 
adjusted for gender and age. 
Results. Hypertension was found in 153 (69.4%) patients (55% in early RA). In 
56.3% of patients, an increase in blood pressure was first recorded after the debut of 
RA. With hypertension in RA, age (odds ratio [OR] 2.06; 95% confidence interval [CI] 
1.51–2.81), seropositivity in the Russian Federation (OR=3.05; 95% CI 1.67–5.57), 
abdominal obesity (OR=3.82; 95% CI 1.89–7.71), body mass index (BMI; OR= 1.15; 
95% CI 1.07–1.24) and long-term prednisone intake (OR = 1.17; 95% CI 1.03–1.33). 
In early RA, the predictors of hypertension were seropositivity in RF (OR=4.62; 95% 
CI 1.67–12.82), RF titer (OR=1.43; 95% CI 1.04–1.96), the number of swollen joints 
out of 28 (OR=1.14; 95% CI 1.03–1.27), DAS 28 (OR=1.64; 95% CI 1.001–2.67), 
HAQ-DI (OR=3.14; 95% CI 1.19–8.25) and BMI (OR=1.14; 95% CI 1.01–1.29). 
Conclusion. Hypertension is widespread in patients with RA, including in early RA. In 
more than half of cases, hypertension develops against the background of RA and is 
associated  with  traditional  risk  factors,  the  presence  of  RF  and  long-term  use  of 
prednisone. The contribution of RA characteristics to the development of hypertension 
is  most  clearly  seen  in  early  RA.  The  results  obtained  indicate  the  need  for  early 
diagnosis  and  effective  treatment  of  hypertension  in  RA  with  adequate  control  of 
inflammatory activity.