ARTERIAL HYPERTENSION IN RHEUMATOID ARTHRITIS
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Keywords: rheumatoid arthritis, arterial hypertension, risk factorsAbstrak
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.
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