Hypertension is a prevalent concern among individuals with early rheumatoid arthritis (RA), particularly in older patients and those with established cardiovascular risk factors, according to new findings published in Rheumatology Advances in Practice. This study highlights the significant health risks associated with RA, emphasizing the importance of monitoring and addressing hypertension early in the disease course.
Brook Hadwen, MS, a PhD student in kinesiology at the University of British Columbia, along with her research team, noted that patients with RA have a 50% to 60% higher likelihood of experiencing cardiovascular events and related mortality compared to the general population. However, these events often occur later in the progression of RA, suggesting an opportunity to identify and modify risk factors for better health outcomes early in the disease.
Despite the known risks, Hadwen pointed out a gap in research regarding the incidence of hypertension and its associated factors in early RA patients. To investigate this, her team analyzed data from 2,052 patients (mean age: 55 years; 71% women) enrolled in the Canadian Early Arthritis Cohort study. They utilized multivariable logistic regression to assess the initial prevalence of hypertension and track its development among those who were not hypertensive at baseline.
At the start of the study, 26% of participants had a hypertension diagnosis, with a higher prevalence observed in men (34%) compared to women (23%). Factors significantly linked to baseline hypertension included older age (odds ratio [OR] = 4.83), diabetes (OR = 3.52), and hyperlipidemia (OR = 2.49). For women, high alcohol consumption (OR = 2.91) and being overweight (OR = 1.83) were additional contributing factors.
Among participants who were initially free of hypertension, 24% developed the condition over a median follow-up of five years. Key predictors for developing hypertension included older age (OR = 2.46), being overweight (OR = 1.95), obesity (OR = 3.52), and having hyperlipidemia (OR = 1.69). Notably, high alcohol consumption was particularly predictive of incident hypertension in men (OR = 4.39), while hyperlipidemia was more significant for women (OR = 2.17).
The researchers concluded that the prevalence of hypertension at the onset of RA is comparable to that of the general population. However, following a diagnosis of RA, patients face a heightened risk of developing hypertension. The characteristics associated with hypertension in RA patients—older age, diabetes, high body mass index (BMI), dyslipidemia, and excessive alcohol intake—are consistent with those in the broader population.
“Given the high frequency of cardiovascular risk factors among RA patients, routine screening for hypertension and management of modifiable risk factors are essential,” the authors stressed. They also called for further research to explore risk factors for hypertension that may evolve as the disease progresses, suggesting that the interplay between RA and cardiovascular health requires ongoing attention.
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