Background Patients with rheumatoid arthritis (RA) have an increased risk of cardiovascular (CV) disease. Monitoring of arterial stiffness could be used as an additional tool of cardiovascular risk assessment.
Objectives of the study is to evaluate the main parameters daily monitoring of arterial stiffness (DMAS) in women with rheumatoid arthritis with or without arterial hypertension (AH).
Methods DMAS was measured in 63 women with RA (ACR 1987 and/or EULAR/ACR 2010 criteria). The first group involved 39 RA female patients with AH (mean age – 58.3±6.08 years; median of RA duration - 8 [4; 14] years, median of DAS 28- 5.08 [4.04; 5.85]), the second group included 24 women with RA without AH (mean age 55±7.15 years; duration of RA is 10 [3; 17] years, mean DAS 28 – 5.25 [4.6; 5.7]).
30 women with AH without RA and other joint diseases and 22 healthy females were involved as a controls. Persons with and without RA were comparable inconventional cardiovascular risk factors. Exclusion criteria were smoking, diabetes mellitus, symptomatic AH, cardiovascular diseases (except AH).
DMAS was measured by using the BPlab with technology VASOTENSE (Russian).An index of arterial stiffness (ASI), a daily index of arterial stiffness (AASI), an aortic pulse wave velocity (PWVao), augmentation index (AIx) were measured. All indexes were estimated at day and night hours.
Statistics was performed with STATISTICA 7.0 (StatSoft, USA).
Results Hypertensive RA patients and AH patients without RA had comparable DMAS parameters (ASI, PWVao, Alx). The AASI index was higher in RA patients without AH versus controls (0.48±0.2 and 0.29±0.17, respectively, p=0.00001) and the AASI index was higher in hypertensive RA patients versus AH patients (0.5±0.2 and 0.38±0.15, respectively, p=0.01). AASI >0.07 revealed at RA patients more often than in controls: at 13.15% of hypertensive RA patients and at 16.6% of RA patients without AH, respectively, p<0.05. The increase of PWVao observed at RA patients frequently than in controls (p<0.05).
Daily index ASI100 was higher in RA patients without AH than in healthy controls (121 [109.5; 139] mmHg vs. 107 [103; 115] mmHg, p=0.014).
The increased of AIx75 was registered in 25% of RA patients without AH and in 9.09% of controls (p=0.08). PWVao and average Aix75 correlates with ESR (r =0.38 and r =0.36, respectively, p<0.05) in RA patients with AH; AASI correlates with level C-reactive protein (r=0.36, p<0.05).
ASI and AASI in RA patients with AH correlates with age (Spearmen's r =0.41 and r =0.36, respectively, p<0.05), systolic blood pressure (r =0.76 and r =0.65, respectively, p<0.05); pulse blood pressure (r=0.77 and r =0.43, respectively, p<0,05).
Conclusions Arterial stiffness, according to daily monitoring, in RA patients is higher than in hypertensive patients without RA and healthy controls. Arterial stiffness in patients with RA and AH is higher than in patients with RA without AH or AH without RA. Age, systolic blood pressure, pulse blood pressure, high levels of ESR and C-reactive protein associated with increased arterial stiffness in RA patients.
Disclosure of Interest None declared