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AB0830 Hypertension during the Treatment of Gouty Arthritis with Nsaids
  1. E. Mikhnevich,
  2. K. Mytnik
  1. Department Of Internal Medicine, University of Medicine, Minsk, Belarus


Background Cardiovascular diseases are common in gout, with the hypertension (HTN) being the most frequent. Taking NSAIDs in patients with gout can result in destabilization of pre-existing HTN or the development of new episodes of HTN.

Objectives to determine the influence of NSAIDs on destabilization of HTN among patients with gouty arthritis and to study a level of compliance to anti-hypertensive treatment (AHT) in such patients.

Methods 436 patients with GA and meeting ACR classification criteria for GA (1977) were recruited during 2009-2012. 88,9% of patients were males with the mean age of 55,4±10,3 years and average disease duration of 7,9±6,8 years. The initial treatment was a NSAID at an adequate dose. We performed the monitoring of blood pressure (BP) during the treatment period in patients with and without HTN. Elevated BP was defined as sitting BP >140/90mmHg. Destabilized HTN was considered as elevated BP with AHT correction. We registered new episodes of HTN and destabilized HTN in patients with GA and pre-existing HTN. Before this observation, 24,8% (n=108) of patients did not suffer from HTN and did not receive any anti- hypertensive drug. 75,2% (n=328) of patients had HTN of various duration and severity.

Results Among 108 patients without HTN before the study, in 9,9% (n=43) of patients, HTN was diagnosed for the first time, and the treatment was prescribed. 328 patients with gout and concomitant HTN were divided into 2 groups: 47,2% (n=206) of patients regularly taking their anti-hypertensive treatment (AHT) and 28% (n=122) of patients taking AHT non-regularly or not taking it at all. Elevated BP during the NSAIDs treatment despite the effective AHT was evidenced in 59,7% (n=123) from 206 patients. On the other hand, in patients without regular AHT, unstable HTN in 74,6% (n=91) from 122 patients was registered. We found a significant difference in the number of patients with destabilized HTN (χ2=6,90; p=0,0086) between the groups.

Conclusions Destabilized HTN during gout flares treated with NSAIDs was observed in 65,2% of patients with pre-existing HTN. In 9,9% of patients HTN was diagnosed for the first time. Among gouty and hypertensive patients, there is a low level of compliance to AHT: 37,2% of them did not regularly receive their AHT. Destabilized HTN in patients with GA induced by NSAIDs was only partly due to non-regular and ineffective AHT.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.1463

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