Glucocorticoid use increases hypertension risk in patients with rheumatoid arthritis

  • Costello RE & al.
  • Rheumatology (Oxford)
  • 27 Jun 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Glucocorticoid (GC) use was associated with an increased risk of hypertension in patients with rheumatoid arthritis (RA).
  • GC doses of ≥7.5mg in particular are associated with hypertension.

Why this matters

  • Physicians need to be aware that GCs increase the risk of hypertension, and to monitor patients’ BP more vigilantly while GCs are prescribed.

Study design

  • This retrospective study included 17,760 patients with incident RA and without hypertension using data from the UK Clinical Practice Research Datalink (CPRD).
  • Funding: supported by the Centre for Epidemiology Versus Arthritis and the National Institute for Health Research Manchester Biomedical Research Centre.

Key results

  • Of 17,760 patients with RA, 7421 (41.8%) were prescribed GCs during follow-up.
  • The overall incident rate of hypertension was 64.1 per 1000 person-years (95% CI, 62.5-65.7).
  • GC use was associated with an increased risk of hypertension (adjusted HR [aHR], 1.17; 95% CI, 1.10-1.24).
  • When categorised by dose, only doses of ≥ 7.5 mg showed statistically significant association with increased risk of hypertension (7.5-14.9 mg: aHR, 1.18; 95% CI, 1.08-1.29; ≥15 mg: aHR, 1.36; 95% CI, 1.18-1.56)
  • No clear pattern was seen for cumulative doses.

Limitations

  • Retrospective design.
  • Possibility of misclassification of medication use.