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RA patients experienced higher systolic blood pressure variability

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Patients with rheumatoid arthritis displayed greater fluctuations in systolic blood pressure compared with patients without rheumatoid arthritis, increasing their cardiovascular and mortality risk, according to research presented at the annual congress of the European League Against Rheumatism in Madrid.

Cardiovascular disease was more likely to occur in patients with rheumatoid arthritis and more unstable systolic blood pressure, researcher Eric L. Matteson, MD, rheumatology chair at Mayo Clinic, Rochester, Minn., said in a press release. “Doctors should be particularly careful to manage [these patients’] cardiovascular risk.”

 

Eric L. Matteson

Matteson and colleagues studied 452 patients with rheumatoid arthritis (RA; mean age, 55.5 years; 31% men) and 436 patients without RA (mean age, 55.7 years; 31% men). Within-subject standard deviation in systolic and diastolic blood pressure (BP) was used to define BP variability in patient data collected from the National Institutes of Health-funded Rochester Epidemiology Project.

There were 13,470 BP measures in the RA cohort (median, 24 measures per patient) and 9,476 in the non-RA cohort (median, 16.5 measures per subject) during a mean follow-up of 7.1 ± 2.7 years and 7.2 ± 2.6 years, respectively. RA patients’ BP was measured less frequently than the non-RA cohort (median 30 days vs. 27 days; P=.93).

Mean systolic BP at RA incidence/index rate for RA patients was 131.2 ± 18.7 mm Hg compared with 128.2 ± 19.3 mm Hg for non-RA patients (P=.018), while the mean diastolic BP was similar between cohorts(75.1 ± 10.9 mm Hg vs. 75.6 ± 11.0 mm Hg; P=.53).

Sixty-four percent of patients with RA had hypertension at index date, compared with 55% of the non-RA cohort. There was a similar proportion of hypertensive patients on antihypertensive medications between cohorts at the index date (33%, RA patients vs. 30%, non-RA) and during follow-up (33% vs. 31% at 10 years).

RA patients had greater visit-to-visit variability in systolic BP (13.8 ± 4.7 mm Hg), but not diastolic BP, than non-RA patients (13 ± 5.2 mm Hg; P=.004, the researchers wrote.

There were 33 cardiovascular (CV) events and 57 deaths among RA patients during follow-up.

“Higher visit-to-visit variability of systolic and diastolic BP was associated with adverse CV outcomes and all-cause mortality in RA, suggesting the need for increased awareness of adverse outcomes in RA patients with unstable BP,” the researchers concluded.

For more information:

Myasoedova E. OP0164: Long-Term Blood Pressure Variability in Patients with Rheumatoid Arthritis (RA) vs. General Population, and Its Impact on Cardiovascular Events and All-Cause Mortality in RA. Presented at: EULAR 2013; June 12-15, Madrid.