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Hypertension in rheumatoid arthritis
V F Panoulas1, G S Metsios, A V Pace
1Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Pensnett Road, Dudley, West Midlands DY1 2HQ, UK.
Rheumatology (Oxford, England)
|May 10, 2008
Summary
Rheumatoid arthritis (RA) patients have higher rates of hypertension (HT), often undiagnosed and undertreated. This review explores HT causes in RA and suggests management strategies, highlighting the need for clinical trials.
Area of Science:
- Rheumatology
- Cardiology
- Clinical Pharmacology
Background:
- Rheumatoid arthritis (RA) is linked to a higher cardiovascular disease burden.
- Hypertension (HT) and dyslipidemia are key risk factors, with HT being highly prevalent yet underdiagnosed/undertreated in RA patients.
Purpose of the Study:
- To review mechanisms contributing to elevated blood pressure in RA patients.
- To examine the role of common RA treatments in hypertension.
- To propose specific screening and management strategies for HT in the RA population.
Main Methods:
- Literature review focusing on the relationship between RA, cardiovascular risk factors, and antihypertensive management.
- Analysis of potential mechanisms linking RA pathophysiology and commonly used RA medications to hypertension.
- Development of evidence-based screening and management recommendations.
Main Results:
- Hypertension is prevalent and often inadequately managed in RA.
- Several mechanisms, including inflammatory processes and RA medications, may contribute to HT in this population.
- Current evidence necessitates further research, particularly prospective randomized controlled trials.
Conclusions:
- RA patients face a significant risk of hypertension, requiring tailored screening and management protocols.
- Understanding the interplay between RA, its treatments, and cardiovascular risk is crucial.
- Prospective studies are essential to validate proposed management strategies for HT in RA.
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