Background Patients with ankylosing spondylitis (AS) have a 2-fold increased death rate compared to the normal population1,2. There is also a 2-3 fold increase in the prevalence of myocardial infarctions when compared to the general population2. Previous studies implicated regular/intermittent NSAID use as a exacerbating factor for hypertension (3% and 9% increase respectively)3. Other factors including active inflammation, raised body mass index (BMI), elevated cholesterol levels, smoking, alcohol excess and sedentary lifestyles invariably play a role in premature cardiovascular disease and mortality.
Objectives To determine the prevalence of hypertension amongst patients with AS.
To consider the most important risk associations for the hypertension in these patients.
Methods In our annual review clinic we assessed NSAID use in 59 AS patients (M=41, F=18) and attempted to correlate this to hypertension (defined as BP>140/90mmHg). We also considered other risk factors for hypertension including alcohol excess (>30units/week) and obesity and morbid obesity (BMI > 25 and BMI > 30), gender and age.
Results 24 AS patients (M=18, F=6) took regular daily NSAIDS, 6 intermittently (M=4, F=2) and 29 (M=19, F= 10) were not taking NSAIDS. We did not find a statistically significant correlation (p= 0.16) between regular/intermittent use of NSAIDS and hypertension.15 (M=11, F=4) were current smokers and 14 ( M=12, F= 2) were ex-smokers. Of the smokers 12 were hypertensive as defined by BP≥140/90mmhg). Of the ex-smokers 6 were hypertensive. 11 lifelong non smokers were hypertensive. There was no statistically significant difference between hypertension in smokers or non smokers with AS.A history of alcohol excess (as defined by ≥30units per week) was elicited in 9 patients. 4 of these smoked and 3 were ex-smokers. There was a correlation (p=0.05) between alcohol excess and hypertension in these patients. 31 AS patients has a BMI ≥25 and 18 of these had a BMI ≥30, which corelated highly with hypertension amongst AS patients p<0.001).
Conclusions In our AS population we found no difference between the prevalence of hypertension in patients using NSAIDS (regularly or intermittently) and not.
Smoking did not appear to influence blood pressure. Obesity was strongly positively correlated with hypertension whereas an alcohol consumption of 30units per week was weakly correlated
Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT. Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis.
Semin Arthritis Rheum 2004;34:585–92.
El Maghraoui A, Extra-articular manifestations of ankylosing spondylitis: Prevalence, characteristics and therapeutic implications, Eur J Intern Med (2011), doi:10.1016/j.ejim.2011.06.006
Wanders A et al. Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial. Arthritis Rheum. 2005 Jun;52(6):1756-65.
Disclosure of Interest None Declared
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