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jsmc-10062


THE IMPLICATION OF RHEUMATOID ARTHRITIS ON BLOOD PRESSURE CONTROL


Asso F. Amin *, Raof Merza *, Kosar Muhammed * and Bahra Omer **


*   Department of Medicine, School of Medicine Faculty of medical sciences, University of Sulaimani.
** General Medical Teaching Hospital (Shaheed Hemn), Sulaimani Directorate of Health, Sulaimani.


Submitted: 11/11/2013; Accepted: 2/6/2014


ABSTRACT


Background

Rheumatoid Arthritis associates with excessive morbidity and mortality from cardiovascular events. Hypertension is considered as a major risk factor for development of cardiovascular disease. Insufficient control of blood pressure appears to be more in Rheumatoid arthritis. However, factors influence the control of blood pressure in rheumatoid arthritis is understudied.

Objectives

To determine the control of blood pressure in rheumatoid arthritis versus non rheumatoid arthritis hypertensive subjects by using ambulatory blood pressure measurement and to identify the factors associated with insufficient control of blood pressure in Rheumatoid arthritis patients.

Patients and Methods

This is a case control study performed on seventy eight patients, 40 Rheumatoid arthritis hypertensive patient and 38 non-Rheumatoid arthritis hypertensive candidates between September 2012 and March 2013. Participants were between 45 and 85 years. An ambulatory blood pressure measurement was carried out for
all patients and an abnormal blood pressure was defined as systolic of more than 140 mm Hg and or diastolic of more than 90mm Hg.

Results

Blood pressure control is significantly lower in rheumatoid arthritis hypertensive patients compared to hypertensive non Rheumatoid arthritis control subjects (p-value 0.034). Furthermore, steroid users had more insufficient control of blood pressure compared to non users (p-value 0.028).There was significant association
between methotrexate use and better control of hypertension (p-value 0.008).

Conclusion

The present study concludes that blood pressure control is lower in rheumatoid arthritis patients compared with non rheumatoid arthritis subjects; this may be of importance in the context of the increased cardiovascular morbidity and mortality. Those with co morbidity may require closer monitoring and treatment strategies.

KEYWORDS

Rheumatoid arthritis, Ambulatory blood pressure measurement.