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
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