Longer spondyloarthritis duration tied to increased risk of developing hypertension

  • Derakhshan MH & al.
  • J Rheumatol
  • 15 Jan 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Hypertension is associated with increased spondyloarthritis (SpA) disease duration and delay in SpA diagnosis.
  •  This association is stronger in patients with axial disease than in those with peripheral disease.

Why this matters

  • Regular blood pressure measurement would help physicians better manage patients with SpA, particularly those with longer disease duration.

Study design

  • Analysis of data from the ASAS-COMOSPA (Assessment of Spondylo-arthritis international Society–COMOrbidities in Spondylo-Arthritis) study (n=3923; median SpA disease duration, 5.1 years; interquartile range, 1.3-11.8 years).
  • Associations between SpA disease duration and CV-related conditions were evaluated using univariable and multivariable logistic regression analyses.
  • Funding: COMOSPA study was supported by AbbVie, Pfizer and UCB.

Key results

  • The main CV-related conditions assessed were hypertension (22.4%), dyslipidaemia (16.6%), ischaemic heart disease (2.6%), stroke (1.3%) and diabetes mellitus (5.5%).
  • Odds of having a diagnosis of hypertension increased by 13% per each 5-year increase in the duration of SpA (OR, 1.13; 95% CI, 1.07-1.19; P<.001>
  • A weak but marginally significant association was observed between hypertension and delay in SpA diagnosis (OR, 1.01; 95% CI, 1.00-1.02; P=.033).
  • Factors associated with hypertension were age, male sex, current body mass index, ever use of steroid therapy and synthetic disease-modifying antirheumatic drug therapy, but not ever use of nonsteroidal anti-inflammatory drugs.
  • Strongest association of hypertension and disease duration was seen in patients with the axial-only SpA phenotype (OR, 1.20; 95% CI, 1.05-1.37) but not in those with peripheral-only SpA (OR, 0.90; 95% CI, 0.76-1.07).
  • Other CV-related conditions showed no association with SpA disease duration.

Limitations

  • Self-reported data may incur recall bias.