Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis.

2.50
Hdl Handle:
http://hdl.handle.net/2436/40235
Title:
Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis.
Authors:
Panoulas, Vasileios F.; Douglas, Karen M. J.; Milionis, Haralampos J.; Stavropoulos-Kalinoglou, Antonios; Nightingale, Peter; Kita, Marina D.; Tselios, Andreas L.; Metsios, Giorgos S.; Elisaf, Moses S.; Kitas, George D.
Abstract:
OBJECTIVES: Rheumatoid arthritis (RA) associates with excessive cardiovascular morbidity and mortality. Hypertension (HT) contributes significantly to the development of cardiovascular disease (CVD). Little is known about the factors that influence blood pressure (BP) in patients with RA. In this study, we assessed the prevalence of HT in a secondary care cohort of RA patients, and aimed to identify factors associated with its presence and inadequate control. METHODS: A total of 400 consecutive RA patients were studied. HT was defined as systolic BP >/=140 mmHg and/or diastolic BP >/=90 mmHg or current use of antihypertensive drugs. The association of HT with several demographic and RA-related factors, comorbidities and drugs was evaluated using logistic regression. RESULTS: HT was present in 282 (70.5%) patients. Of those, 171 (60.6%) received anti-hypertensive therapy, but 111 (39.4%) remained undiagnosed. Of those treated, only 37/171 (21.8%) were optimally controlled. Multivariable logistic regression revealed age (OR = 1.054, CI: 1.02 to 1.07, P = 0.001), body mass index [BMI (OR = 1.06, CI: 1.003-1.121, P = 0.038)] and prednisolone use (OR = 2.39, CI: 1.02-5.6, P = 0.045) to be independently associated with the presence of HT. BMI (OR = 1.11, CI: 1.02-1.21, P = 0.002) and the presence of CVD (OR = 4.01, CI: 1.27-12.69, P = 0.018) associated with uncontrolled HT. CONCLUSIONS: HT is highly prevalent in RA, under-diagnosed particularly in the young, and under-treated particularly in old RA patients with CVD. RA patients receiving steroids should be specifically targeted for screening and treatment; those with any cardiovascular comorbidity may require particularly aggressive monitoring and treatment strategies.
Citation:
Rheumatology, 46 (9): 1477-82
Publisher:
Oxford University Press
Journal:
Rheumatology
Issue Date:
2007
URI:
http://hdl.handle.net/2436/40235
DOI:
10.1093/rheumatology/kem169
PubMed ID:
17704521
Additional Links:
http://rheumatology.oxfordjournals.org/cgi/content/full/46/9/1477
Type:
Article
Language:
en
Description:
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Rheumatology following peer review. The definitive publisher-authenticated version in Rheumatology 2007 46(9), 1477-1482, is available online at the links given above.
ISSN:
1462-0324
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.authorStavropoulos-Kalinoglou, Antonios-
dc.contributor.authorNightingale, Peter-
dc.contributor.authorKita, Marina D.-
dc.contributor.authorTselios, Andreas L.-
dc.contributor.authorMetsios, Giorgos S.-
dc.contributor.authorElisaf, Moses S.-
dc.contributor.authorKitas, George D.-
dc.date.accessioned2008-11-04T12:44:59Z-
dc.date.available2008-11-04T12:44:59Z-
dc.date.issued2007-
dc.identifier.citationRheumatology, 46 (9): 1477-82en
dc.identifier.issn1462-0324-
dc.identifier.pmid17704521-
dc.identifier.doi10.1093/rheumatology/kem169-
dc.identifier.urihttp://hdl.handle.net/2436/40235-
dc.descriptionThis is a pre-copy-editing, author-produced PDF of an article accepted for publication in Rheumatology following peer review. The definitive publisher-authenticated version in Rheumatology 2007 46(9), 1477-1482, is available online at the links given above.en
dc.description.abstractOBJECTIVES: Rheumatoid arthritis (RA) associates with excessive cardiovascular morbidity and mortality. Hypertension (HT) contributes significantly to the development of cardiovascular disease (CVD). Little is known about the factors that influence blood pressure (BP) in patients with RA. In this study, we assessed the prevalence of HT in a secondary care cohort of RA patients, and aimed to identify factors associated with its presence and inadequate control. METHODS: A total of 400 consecutive RA patients were studied. HT was defined as systolic BP >/=140 mmHg and/or diastolic BP >/=90 mmHg or current use of antihypertensive drugs. The association of HT with several demographic and RA-related factors, comorbidities and drugs was evaluated using logistic regression. RESULTS: HT was present in 282 (70.5%) patients. Of those, 171 (60.6%) received anti-hypertensive therapy, but 111 (39.4%) remained undiagnosed. Of those treated, only 37/171 (21.8%) were optimally controlled. Multivariable logistic regression revealed age (OR = 1.054, CI: 1.02 to 1.07, P = 0.001), body mass index [BMI (OR = 1.06, CI: 1.003-1.121, P = 0.038)] and prednisolone use (OR = 2.39, CI: 1.02-5.6, P = 0.045) to be independently associated with the presence of HT. BMI (OR = 1.11, CI: 1.02-1.21, P = 0.002) and the presence of CVD (OR = 4.01, CI: 1.27-12.69, P = 0.018) associated with uncontrolled HT. CONCLUSIONS: HT is highly prevalent in RA, under-diagnosed particularly in the young, and under-treated particularly in old RA patients with CVD. RA patients receiving steroids should be specifically targeted for screening and treatment; those with any cardiovascular comorbidity may require particularly aggressive monitoring and treatment strategies.en
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttp://rheumatology.oxfordjournals.org/cgi/content/full/46/9/1477en
dc.subjectHypertensionen
dc.subjectRheumatoid Arthritisen
dc.subjectPrevalenceen
dc.subjectCardiovascularen
dc.subjectControlen
dc.subject.meshAge Factorsen
dc.subject.meshAgeden
dc.subject.meshAntihypertensive Agentsen
dc.subject.meshAntirheumatic Agentsen
dc.subject.meshArthritis, Rheumatoiden
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshEnglanden
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshHypertensionen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshPrevalenceen
dc.subject.meshRisk Factorsen
dc.subject.meshSeverity of Illness Indexen
dc.titlePrevalence and associations of hypertension and its control in patients with rheumatoid arthritis.en
dc.typeArticleen
dc.identifier.journalRheumatologyen

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