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AB0364 Characteristics of blood pressure phehotypes in patients with rheumatoid arthritis - eular
  1. S Velmakin,
  2. E Troitskaya,
  3. S Villevalde,
  4. Z Kobalava
  1. Propaedeutics of Internal Diseases, Rudn University, Moscow, Russian Federation

Abstract

Background Patients with rheumatoid arthritis (RA) have increased cardiovascular risk. Arterial hypertension (AH) is highly prevalent, and seems to be under-diagnosed and under-treated among patients with RA. Data on ABPM profile in patients with rheumatoid arthritis are lacking.

Objectives The aim of the study was to evaluate ABPM parameters and characterize phenotypes of blood pressure (BP) in patients with RA.

Methods 62 patients with RA (EULAR 2010) without known cardio-vascular disease were examined (73% females, age 58,5±15,4 (M±SD) years, 13% smokers, 61% with AH, 34% with dyslipidemia). Median duration of RA was 8 years (IQR 3–17). Seropositive RA was diagnosed in 69% of patients. Median CRP was 12,1 mg/dl (IQR 2,2–23,4 mg/dl), median rheumatoid factor (RF) was 32,5 IU/ml (IQR 8,3–173 IU/ml). All patients received disease-modifying antirheumatic drugs (DMARDs), 22 (38%) - biological treatment. Median duration of AH was 6,1 years (IQR 0–10 years). All patients with AH received antihypertensive treatment. 24-h peripheral and central BP monitoring was performed (BPLab Vasotens, “Petr Telegin”). P<0.05 was considered significant.

Results Mean office BP was 130±15/80±10 mmHg (peripheral) and 123±21/80±10 mmHg (central). 10 (17%) patients had elevated office BP (>140/90 mmHg). Mean BP values for peripheral and central BP were as follows: 125±15/73±9 and 116±14/75±9 mmHg for 24-h BP; 127±15/74±9 and 117±14/77±9 mmHg for daytime BP; 119±15/69±10 and 112±15/70±10 mmHg for nighttime BP. AH according to daytime BP was found in 15 (24,2%) pts, nighttime BP – in 29 (46,8%) pts, 24-h BP - in 19 (30,6%) pts. Phenotypes of BP were as follows: sustained normotension – in 38 (61,2%), masked hypertension in 12 (19,4%), sustained AH – in 10 (16,1%), white-coat hypertension in 2 (3,2%) patients. Isolated nocturnal AH was observed in 12 (19,4%) pts. 10 (16,1%) patients had isolated elevated central BP. 20 (32,3%) pts had elevated central SBP according to individual reference values; all patients with high office BP had elevated central BP.

Conclusions Patients with RA free of CVD are characterized by high prevalence of with the satisfactory control of office BP in the majority of patients. Relatively high prevalence of masked and isolated nocturnal hypertension despite antihypertensive treatment is observed in this population. These findings may help to optimize hypertension treatment in patients with RA.

References

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  2. Avina-Zubieta JA et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum 2008; 59:1690–7.

  3. Protogerou A.D., Panagiotakos D.B., Zampeli E. Arterial hypertension assessed “out-of-office” in a contemporary cohort of rheumatoid arthritis patients free of cardiovascular disease is characterized by high prevalence, low awareness, poor control and increased vascular damage-associated “white coat” phenomenon. Arthritis Res Ther. 2013;15(5):R142.

  4. Panoulas V.F., Metsios G.S., Pace A.V. Hypertension in rheumatoid arthritis. Rheumatology (Oxford). 2008;47(9):1286–98.

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References

Disclosure of Interest None declared

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