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SAT0090 Success rate of blood pressure goal achievement in inflammatory joint diseases
  1. S Rollefstad,
  2. P Norheim,
  3. E Ikdahl,
  4. G Wibetoe,
  5. AG Semb
  1. Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway

Abstract

Background The excess risk of cardiovascular disease (CVD) in patients with inflammatory joint diseases (IJD) is attributable to several risk factors, including a high prevalence of hypertension. However, there is limited knowledge on the effect of antihypertensive treatment (a-HTT) in these patients.

Objectives Our objective was to initiate a-HTT when indicated and treat to guideline recommended blood pressure (BP) goal in IJD patients. We also aimed to evaluate the effect of a-HTT in this patient population, and which factors were associated with BP goal attainment.

Methods Patients with IJD (n=765) were referred from a rheumatology outpatient clinic or general practitioners to a preventive cardio-rheuma clinic. All patients underwent a CVD risk evaluation, including BP measurements (performed using and Omron M7 apparatus). Antihypertensive treatment was initiated in accordance with guidelines, and the BP treatment goal was <140/90 mmHg.

Results Of the 765 IJD patients referred (rheumatoid arthritis n=450, ankylosing spondylitis n=210 and psoriatic arthritis n=105), 104 (13.6%) had an indication for BP lowering, while 224 (29.3%) were already using a-HTT at the first consultation. For those where a-HTT was initiated at baseline (n=104), there was a highly significant change in BP from first to final consultation (Fig 1a). BP goal was achieved in 84 (80.8%) patients (Fig 1b), using mean±SD 3.1±1.7 consultations. Dose adjustments was done in 38 (36.5%) of the patients with median (IQR) a-HTT dose adjustments of 1 (1, 1.25). In 9 (8.7%) patients the a-HTT was changed. Systolic BP (p<0.0001) was significantly associated with BP goal attainment in age- and sex adjusted logistic regression analyses, while the use of anti-rheumatic medication or inflammatory biomarkers at baseline was not. Patients with the lowest systolic BP were more likely to achieve BP goals. For patients already on a-HTT (n=224), only 52.7% had a BP <140/90 mmHg at baseline. After up titration or change of a-HTT, the percentage of patients achieving BP goal in this group increased to 82.6%.

Conclusions This is to our knowledge the first prospective report on success rate of BP goal achievement in patients with IJD. Approximately 80% reached BP target, which is even a higher proportion than what is shown in the general population. Treatment to BP goal is feasible in patients with IJD, and is not complicated by inflammation or use of anti-rheumatic medication.

Disclosure of Interest None declared

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