Early Rheumatoid Arthritis Linked to high incident hypertension, suggests study

RA is a chronic inflammatory condition that predisposes a person to high risks of cardiovascular diseases. Hypertension remains a challenge to patients diagnosed with RA; increased levels may worsen the outcome of cardiovascular complications in these patients. However, factors specifically contributing to hypertension in early RA patients, particularly those with a history of less than one year, are not well understood. This study was conducted to investigate prevalence at diagnosis of RA and to assess the incidence of new cases at follow-up, with particular emphasis on the baseline risk factors that may lead to development of hypertension in RA patients.

This study involved analyzing data of the Canadian Early Arthritis Cohort (CATCH) cohort of RA patients who were diagnosed within one year of the time frame when disease onset started. The diagnosis of hypertension was determined based on patient and physician reports, blood pressure recordings, and the use of antihypertensive drugs. Baseline correlates of hypertension were explored through multivariable logistic regression of demographic, lifestyle, and clinical covariates that could impact the risks for hypertension.

• The analysis included 2052 early RA patients. Mean age was 55 years (SD 14) and female dominance (71%).

• Hypertension was prevalent at the time of diagnosis of RA in 26% of the subjects, and higher proportions were depicted by males at 34% and by females at 23%.

• Both male and female participants demonstrated a correlation between hypertension and age( > or = 60 years), diabetes, and hyperlipidemia. High alcohol intake was also strongly associated with hypertension in women, as well as a high BMI.

• Among 1,518 RA patients without prevalent hypertension at baseline, a total of 24% (364 patients) developed hypertension during a median follow-up of 5 years (range 1–8 years).

• Significant risk factors for newly diagnosed hypertension were older age, over weightness, excessive alcohol intake and hyperlipidemia.

• High alcohol consumption was significantly a major risk factor for new incidence of hypertension in males and the risk factor for females was hyperlipidemia.

A strong aspect relating to lifestyle and metabolic risk factor management is argued to be prioritized in early RA care to decrease the potential risk of hypertension and improve cardiovascular outcomes for these patients. Preventive monitoring of blood pressure and cardiovascular risk assessments at appropriate times can be important aspects of management in RA for the prevention of cardiovascular complications from early stages.

Reference:

Hadwen, B., Stranges, S., Pope, J. E., Bartlett, S., Boire, G., Bessette, L., Hitchon, C. A., Hazlewood, G., Keystone, E. C., Schieir, O., Thorne, C., Tin, D., Valois, M.-F., Bykerk, V., Barra, L., CATCH Investigators, Akhavan, P., Bessette, L., Boire, G., … Zummer, M. (2024). Risk factors for prevalent and incident hypertension in rheumatoid arthritis: data from the Canadian Early Arthritis Cohort. Rheumatology Advances in Practice, 8(2), rkae066. https://doi.org/10.1093/rap/rkae066