Long-term exposure to medium-dose glucocorticoid therapy associates with hypertension in patients with rheumatoid arthritis

2.50
Hdl Handle:
http://hdl.handle.net/2436/40204
Title:
Long-term exposure to medium-dose glucocorticoid therapy associates with hypertension in patients with rheumatoid arthritis
Authors:
Panoulas, Vasileios F.; Douglas, Karen M. J.; Milionis, Haralampos J.; Metsios, Giorgos S.; Stavropoulos-Kalinoglou, Antonios; Nightingale, Peter; Kita, Marina D.; Elisaf, Moses S.; Kitas, George D.
Abstract:
OBJECTIVE: Rheumatoid arthritis (RA) associates with increased cardiovascular morbidity and mortality that is due to both traditional and novel cardiovascular risk factors. Hypertension (HT), one of the most common risk factors for cardiovascular disease, is highly prevalent in RA. The effects of long-term glucocorticoid (GC) therapy on blood pressure have not been established yet. This study examined whether GC exposure associates with HT in patients with RA. METHODS: Four hundred consecutive RA patients with detailed clinical and laboratory assessments were categorized into three groups according to GC exposure: no or limited exposure (N/L-E); a low-dose (< 7.5 mg) long-term exposure (LD/LT-E); and medium-dose (> or = 7.5 mg) long-term exposure (MD/LT-E). The association of GC exposure with HT was evaluated using logistic regression analysis. RESULTS: HT was more prevalent in the MD/LT-E group (84.7%) than the LD/LT-E or N/L-E groups (70.7 and 67.3%, respectively, P = 0.028). Logistic regression revealed increased odds for HT when comparing MD/LT-E with N/L-E, after adjustment for HT risk factors [odds ratio (OR) = 2.57, 95% CI 1.01-6.56, P = 0.049] and RA disease characteristics (OR = 3.64, 95% CI: 1.36-9.77, P = 0.01). CONCLUSIONS: MD/LT GC exposure associates with a very high prevalence of HT. This appears to be independent of other risk factors for HT or of channelling bias due to disease severity, even though the latter cannot be excluded given the cross-sectional nature of our study. RA patients in this GC exposure group should be particularly targeted for early identification and aggressive management of HT.
Citation:
Rheumatology, 47(1): 72-75
Publisher:
Oxford University Press
Journal:
Rheumatology
Issue Date:
2008
URI:
http://hdl.handle.net/2436/40204
DOI:
10.1093/rheumatology/kem311
PubMed ID:
18077493
Additional Links:
http://rheumatology.oxfordjournals.org/cgi/content/abstract/47/1/72
Type:
Article
Language:
en
ISSN:
1462-0332
Appears in Collections:
Sport, Exercise and Health Research Group

Full metadata record

DC FieldValue Language
dc.contributor.authorPanoulas, Vasileios F.-
dc.contributor.authorDouglas, Karen M. J.-
dc.contributor.authorMilionis, Haralampos J.-
dc.contributor.authorMetsios, Giorgos S.-
dc.contributor.authorStavropoulos-Kalinoglou, Antonios-
dc.contributor.authorNightingale, Peter-
dc.contributor.authorKita, Marina D.-
dc.contributor.authorElisaf, Moses S.-
dc.contributor.authorKitas, George D.-
dc.date.accessioned2008-11-04T11:32:44Z-
dc.date.available2008-11-04T11:32:44Z-
dc.date.issued2008-
dc.identifier.citationRheumatology, 47(1): 72-75en
dc.identifier.issn1462-0332-
dc.identifier.pmid18077493-
dc.identifier.doi10.1093/rheumatology/kem311-
dc.identifier.urihttp://hdl.handle.net/2436/40204-
dc.description.abstractOBJECTIVE: Rheumatoid arthritis (RA) associates with increased cardiovascular morbidity and mortality that is due to both traditional and novel cardiovascular risk factors. Hypertension (HT), one of the most common risk factors for cardiovascular disease, is highly prevalent in RA. The effects of long-term glucocorticoid (GC) therapy on blood pressure have not been established yet. This study examined whether GC exposure associates with HT in patients with RA. METHODS: Four hundred consecutive RA patients with detailed clinical and laboratory assessments were categorized into three groups according to GC exposure: no or limited exposure (N/L-E); a low-dose (< 7.5 mg) long-term exposure (LD/LT-E); and medium-dose (> or = 7.5 mg) long-term exposure (MD/LT-E). The association of GC exposure with HT was evaluated using logistic regression analysis. RESULTS: HT was more prevalent in the MD/LT-E group (84.7%) than the LD/LT-E or N/L-E groups (70.7 and 67.3%, respectively, P = 0.028). Logistic regression revealed increased odds for HT when comparing MD/LT-E with N/L-E, after adjustment for HT risk factors [odds ratio (OR) = 2.57, 95% CI 1.01-6.56, P = 0.049] and RA disease characteristics (OR = 3.64, 95% CI: 1.36-9.77, P = 0.01). CONCLUSIONS: MD/LT GC exposure associates with a very high prevalence of HT. This appears to be independent of other risk factors for HT or of channelling bias due to disease severity, even though the latter cannot be excluded given the cross-sectional nature of our study. RA patients in this GC exposure group should be particularly targeted for early identification and aggressive management of HT.en
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttp://rheumatology.oxfordjournals.org/cgi/content/abstract/47/1/72en
dc.subjectSteroidsen
dc.subjectCardiovascular Diseaseen
dc.subjectRheumatoid Arthritisen
dc.subject.meshAgeden
dc.subject.meshArthritis, Rheumatoiden
dc.subject.meshBlood Pressureen
dc.subject.meshCohort Studiesen
dc.subject.meshComorbidityen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshDose-Response Relationship, Drugen
dc.subject.meshFemaleen
dc.subject.meshGlucocorticoidsen
dc.subject.meshGreat Britainen
dc.subject.meshHumansen
dc.subject.meshHypertensionen
dc.subject.meshLogistic Modelsen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshPrednisoloneen
dc.subject.meshRisk Factorsen
dc.titleLong-term exposure to medium-dose glucocorticoid therapy associates with hypertension in patients with rheumatoid arthritisen
dc.typeArticleen
dc.identifier.journalRheumatologyen

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