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Hypertension and Cardiovascular Outcomes in Inflammatory and Autoimmune Diseases: A Systematic Review and

Marie Barozet1, Olivier Le Tilly2,3, Theodora Bejan-Angoulvant2,3

  • 1Department of Internal Medicine, Montpellier University Hospital, Montpellier, France.

Current Hypertension Reports
|May 31, 2024
PubMed

Insights

Patients with inflammatory and autoimmune diseases (IAD) face higher risks of hypertension and cardiovascular complications. Early screening and management of hypertension are crucial for improving outcomes in this population.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Inflammatory and autoimmune diseases (IAD) are associated with increased cardiovascular (CV) mortality and complications.
  • Hypertension and chronic inflammation are key risk factors contributing to CV issues in IAD patients.

Purpose of the Study:

  • To investigate the prevalence of hypertension and associated CV complications in patients with various IAD.
  • To identify factors influencing hypertension risk within IAD cohorts.

Main Methods:

  • Systematic literature search of MEDLINE and EMBASE for controlled studies (Jan 2000-Mar 2022).
  • Inclusion of studies on hypertension and CV complications in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriasis, psoriatic arthritis (PsA), Sjogren's syndrome (SS), and antineutrophil cytoplasmic antibody-associated vasculitis (AAV).
  • Random-effects meta-analyses and meta-regression to determine prevalence and associated factors.

Main Results:

  • A meta-analysis of 122 studies revealed a higher prevalence of hypertension in IAD patients (adjusted OR 1.36 [1.24-1.50]).
  • All investigated IADs showed an increased risk of hypertension, with SLE having the highest adjusted OR (3.40 [1.93-6.00]).
  • Increased risks were observed for ischemic heart disease (OR 1.38), cerebrovascular disease (OR 1.37), heart failure (OR 1.28), and atherosclerotic plaques (OR 2.46).

Conclusions:

  • Patients with IAD exhibit a significantly higher prevalence of hypertension and CV complications.
  • Age and female sex were identified as significant factors associated with hypertension in IAD.
  • Proactive screening and management of hypertension are essential for mitigating CV risks in individuals with IAD.
Abstract

Keywords:
Autoimmune diseasesCardiovascular complicationsCardiovascular riskHypertensionInflammatory diseases

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