Background Spondyloarthritis (SpA) (ankylosing spondylitis (AS) and psoriatic arthritis (PsA)) are associated with increased cardiovascular risk . Destabilization of arterial pressure in chronic inflammation and anti-inflammatory treatment could be one of the reasons of early cardiovascular events onset.
Objectives The purpose of this work is evaluate the occurrence and risk of arterial hypertension (AH) onset in patients with AS and PsA.
Methods 663 patients were involved in the study: AS patients fulfilled mNew-York criteria (1984), PsA patients fulfilled CASPAR criteria (2006). Study included cross-sectional analyze, where 159 AS and 85 PsA patients participated, and 10-year prospective follow-up part, included 278 AS patients, 109 PsA patients. 276 patients were excluded due to lose the follow-up. In follow-up part of the study were involved SpA patients without AH at baseline. 182 healthy volunteers participated in the study like controls, 32 of them lost the follow-up. New cases of AH were registered after 4 and 10 years.
Statistics was performed in SPSS17 and GraphPadPrizm. All the results were adjusted to cardiovascular risk factors.
Results Characteristics of the patients and controls with 10-years follow-up are presented in table 1.
100% of patients recieved NSAIDs, 10% - glucocorticoids (5–10 mg prednisolone), 68.8% of PsA patients recieved methotrexate (10–25 mg/week), 14.3 of AS patients - sulfasalazine (2.0–3.0 g/day).
Due to cross-sectional analyses was shown that AH occurred in 48.7 of AS and in 67.5% of PsA patients, respectively, p=0.03.
Numbers of new AH cases during follow-up are presented in table 2.
The relative risk (RR) of AH onset in patients with AS compared to healthy individuals is 2.22 (95% confidential interval (CI) 1.59 - 3.1); RR in PsA patients is 3.08 (95% CI 2.19 - 4.03), difference between risk of AH development in PsA and AS is significant, p<0.0001. Median to new AH cases in AS and PsA is 10±2.57 years from the first SpA symptoms appearance.
Conclusions AH is frequently presented in PsA patients than in AS. Risk of new AH onset in patients with AS and PsA is superior compared with the healthy individuals. The number of new cases of hypertension increases with time, and in 10 years from diagnosis half of PsA/AS patients without cardiovascular disease will be in the risk of hypertension.
Agca R et al. Ann Rheum Dis. 2017 Jan;76(1):17–28.
Disclosure of Interest None declared