The prevalence and risk factors of arterial hypertension in rheumatoid arthritis

Abstract

Objective: to assess the prevalence and risk factors of arterial hypertension (AH) in young and middle-aged patients with rheumatoid arthritis (RA). Subjects and methods. Two hundred and twenty-two patients with RA (34% with early RA) who had no concomitant symptoms of cardiovascular disease were examined. Their mean age was 47±9.7 years (15% were males); 60% of the patients were seropositive for rheumatoid factor (RF); a mean DAS 28 score was 5.77±1.1; a mean HAQ-DI score, 1.58±0.7. Logistic regression models were used to study associations between AH and risk factors adjusting for age and sex. Results. AH was found in 153 (69.4%) patients with RA (55% with early RA). Elevated blood pressure was first documented in 56.3% patients after RA onset. Age (odds ratio [OR] 2.06; 95% confidence interval [CI] 1.51—2.81), RF seropositivity (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 prednisolone use (OR = 1.17; 95% CI 1.03—1.33) were associated with AH in RA. In early RA, RF seropositivity (OR = 4.62; 95% CI 1.67—12.82), RF titer (OR = 1.43, 95% CI 1.04—1.96), DAS 28 swollen joints (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) were associated with AH. Conclusion. AH is very common in patients with RA, including those with early RA. In more than half of cases, AH develops in the presence of RA and associated with traditional risk factors, RF, and long-term prednisolone intake. The contribution of RA characteristics to the development of AH is more apparent in early RA. The findings suggest that there is a need for the early diagnosis and effective treatment of AH in RA with adequate RA activity control.