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Erschienen in: Zeitschrift für Rheumatologie 2/2019

12.04.2018 | Originalien

Nocturnal blood pressure dipping is similar in rheumatoid arthritis patients as compared to a normal population

verfasst von: O. Turgay Yildirim, E. Gonullu, F. Aydin, E. Aksit, A. Huseyinoglu Aydin, E. Dagtekin

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 2/2019

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Abstract

Objective

Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disorder which further doubles the risk of developing cardiovascular disease. Some studies suggest that in RA patients, the prevalence of hypertension increases due to prednisolone use, clinical status, genetic factors, and physical inactivity. On the other hand, dipper and non-dipper status in RA patients compared to non-RA subjects has not been investigated to our knowledge. Purpose of the study is to investigate whether non-dipper status is more deteriorated in RA patients.

Methods

Sixty-five RA patients and 61 age-sex-matched control patients were evaluated in this cross-sectional study. Patients were classified according to 24-h ambulatory blood pressure monitoring results. Patients with previous hypertension diagnosis, coronary artery disease, and abnormal kidney function were excluded.

Results

Mean age of the study sample was 53.7 ± 12.3 years and 40.5% were male. There was no significant difference between groups in terms of basic demographic characteristics. Leukocyte counts (p = 0.001), neutrophil counts (p = 0.001), and red cell distribution width (p = 0.000) were significantly higher in the RA group. ABPM results indicate no significant difference between RA patients and the control group in terms of daytime systolic and diastolic blood pressure, nighttime systolic and diastolic blood pressure, and average systolic and diastolic blood pressure results (p > 0.05). There was no statistical difference regarding the non-dipper status of patient groups (p = 0.412). Nocturnal blood pressure dipping was significantly similar between groups (p = 0.980).

Conclusion

In conclusion, RA patients have similar values in terms of nocturnal blood pressure dipping and hypertension diagnosis as compared to normal population.
Literatur
1.
Zurück zum Zitat Gabriel SE (2001) The epidemiology of rheumatoid arthritis. Rheum Dis Clin North Am 27:269–281CrossRef Gabriel SE (2001) The epidemiology of rheumatoid arthritis. Rheum Dis Clin North Am 27:269–281CrossRef
2.
Zurück zum Zitat Turesson C, Jacobsson LT, Matteson EL (2008) Cardiovascular co-morbidity in rheumatic diseases. Vasc Health Risk Manag 4:605–614CrossRef Turesson C, Jacobsson LT, Matteson EL (2008) Cardiovascular co-morbidity in rheumatic diseases. Vasc Health Risk Manag 4:605–614CrossRef
3.
Zurück zum Zitat Wolfe F, Mitchell DM, Sibley JT, Fries JF, Bloch DA, Williams CA et al (1994) The mortality of rheumatoid arthritis. Arthritis Rheum 37:481–494CrossRef Wolfe F, Mitchell DM, Sibley JT, Fries JF, Bloch DA, Williams CA et al (1994) The mortality of rheumatoid arthritis. Arthritis Rheum 37:481–494CrossRef
4.
Zurück zum Zitat Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE et al (2003) Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 107:1303–1307CrossRef Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE et al (2003) Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 107:1303–1307CrossRef
5.
Zurück zum Zitat Aviña-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D (2008) Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum 59:1690–1697CrossRef Aviña-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D (2008) Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum 59:1690–1697CrossRef
6.
Zurück zum Zitat Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): case-control study. Lancet 364:937–952CrossRef Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): case-control study. Lancet 364:937–952CrossRef
7.
Zurück zum Zitat Panoulas VF, Douglas KM, Milionis HJ, Stavropoulos-Kalinglou A, Nightingale P, Kita MD et al (2007) Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis. Rheumatology (Oxford) 46:1477–1482CrossRef Panoulas VF, Douglas KM, Milionis HJ, Stavropoulos-Kalinglou A, Nightingale P, Kita MD et al (2007) Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis. Rheumatology (Oxford) 46:1477–1482CrossRef
8.
Zurück zum Zitat Chung CP, Giles JT, Petri M, Szklo M, Post W, Blumenthal RS et al (2012) Prevalence of traditional modifiable cardiovascular risk factors in patients with rheumatoid arthritis: comparison with control subjects from the multi-ethnic study of atherosclerosis. Semin Arthritis Rheum 41:535–544CrossRef Chung CP, Giles JT, Petri M, Szklo M, Post W, Blumenthal RS et al (2012) Prevalence of traditional modifiable cardiovascular risk factors in patients with rheumatoid arthritis: comparison with control subjects from the multi-ethnic study of atherosclerosis. Semin Arthritis Rheum 41:535–544CrossRef
9.
Zurück zum Zitat Klarenbeek NB, van der Kooij SM, Huizinga TJ, Goekoop-Ruiterman YP, Hulsmans HM, van Krugten MV et al (2010) Blood pressure changes in patients with recent-onset rheumatoid arthritis treated with four different treatment strategies: a post hoc analysis from the BeSt trial. Ann Rheum Dis 69:1342–1345CrossRef Klarenbeek NB, van der Kooij SM, Huizinga TJ, Goekoop-Ruiterman YP, Hulsmans HM, van Krugten MV et al (2010) Blood pressure changes in patients with recent-onset rheumatoid arthritis treated with four different treatment strategies: a post hoc analysis from the BeSt trial. Ann Rheum Dis 69:1342–1345CrossRef
10.
Zurück zum Zitat Metsios GS, Stavropoulos-Kalinoglou A, Panoulas VF, Wilson M, Nevill AM, Koutedakis Y et al (2009) Association of physical inactivity with increased cardiovascular risk in patients with rheumatoid arthritis. Eur J Cardiovasc Prev Rehabil 16:188–194CrossRef Metsios GS, Stavropoulos-Kalinoglou A, Panoulas VF, Wilson M, Nevill AM, Koutedakis Y et al (2009) Association of physical inactivity with increased cardiovascular risk in patients with rheumatoid arthritis. Eur J Cardiovasc Prev Rehabil 16:188–194CrossRef
11.
Zurück zum Zitat Panoulas VF, Douglas KM, Smith JP, Taffé P, Stavropoulos-Kalinoglou A, Toms TE et al (2008) Polymorphisms of the endothelin-1 gene associate with hypertension in patients with rheumatoid arthritis. Endothelium 15:203–212CrossRef Panoulas VF, Douglas KM, Smith JP, Taffé P, Stavropoulos-Kalinoglou A, Toms TE et al (2008) Polymorphisms of the endothelin-1 gene associate with hypertension in patients with rheumatoid arthritis. Endothelium 15:203–212CrossRef
12.
Zurück zum Zitat Panoulas VF, Douglas KM, Smith JP, Metsios GS, Elisaf MS, Nightingale P et al (2009) Galectin-2 (LGALS2) 3279 C/T polymorphism may be independently associated with diastolic blood pressure in patients with rheumatoid arthritis. Clin Exp Hypertens 31:93–104CrossRef Panoulas VF, Douglas KM, Smith JP, Metsios GS, Elisaf MS, Nightingale P et al (2009) Galectin-2 (LGALS2) 3279 C/T polymorphism may be independently associated with diastolic blood pressure in patients with rheumatoid arthritis. Clin Exp Hypertens 31:93–104CrossRef
13.
Zurück zum Zitat Stamatelopoulos KS, Kitas GD, Papamichael CM, Chryssohoou E, Kyrkou K, Georgiopoulos G et al (2009) Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study. Arterioscler Thromb Vasc Biol 29:1702–1708CrossRef Stamatelopoulos KS, Kitas GD, Papamichael CM, Chryssohoou E, Kyrkou K, Georgiopoulos G et al (2009) Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study. Arterioscler Thromb Vasc Biol 29:1702–1708CrossRef
14.
Zurück zum Zitat Kitas GD, Gabriel SE (2011) Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Ann Rheum Dis 70:8–14CrossRef Kitas GD, Gabriel SE (2011) Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Ann Rheum Dis 70:8–14CrossRef
15.
Zurück zum Zitat Mancia G, Parati G (2000) Ambulatory blood pressure monitoring and organ damage. Hypertension 36:894–900CrossRef Mancia G, Parati G (2000) Ambulatory blood pressure monitoring and organ damage. Hypertension 36:894–900CrossRef
16.
Zurück zum Zitat Salles GF, Reboldi G, Fagard RH, Cardoso CR, Pierdomenico SD, Verdecchia P et al (2016) Prognostic effect of the nocturnal blood pressure fall in hypertensive patients: the ambulatory blood pressure collaboration in patients with hypertension (ABC-H) meta-analysis. Hypertension 67:693–700CrossRef Salles GF, Reboldi G, Fagard RH, Cardoso CR, Pierdomenico SD, Verdecchia P et al (2016) Prognostic effect of the nocturnal blood pressure fall in hypertensive patients: the ambulatory blood pressure collaboration in patients with hypertension (ABC-H) meta-analysis. Hypertension 67:693–700CrossRef
17.
Zurück zum Zitat Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham 3rd CO et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581CrossRef Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham 3rd CO et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581CrossRef
18.
Zurück zum Zitat Grassi G, Seravalle G, Quarti-Trevano F, Dell’Oro R, Bombelli M, Cuspidi C et al (2008) Adrenergic, metabolic, and reflex abnormalities in reverse and extreme dipper hypertensives. Hypertension 52:925–931CrossRef Grassi G, Seravalle G, Quarti-Trevano F, Dell’Oro R, Bombelli M, Cuspidi C et al (2008) Adrenergic, metabolic, and reflex abnormalities in reverse and extreme dipper hypertensives. Hypertension 52:925–931CrossRef
19.
Zurück zum Zitat Castelpoggi CH, Pereira VS, Fiszman R, Cardoso CR, Muxfeldt ES, Salles GF (2009) A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in patients with resistant hypertension. Hypertens Res 32:591–596CrossRef Castelpoggi CH, Pereira VS, Fiszman R, Cardoso CR, Muxfeldt ES, Salles GF (2009) A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in patients with resistant hypertension. Hypertens Res 32:591–596CrossRef
20.
Zurück zum Zitat Känel R, Jain S, Mills PJ, Nelesen RA, Adler KA, Hong S et al (2004) Relation of nocturnal blood pressure dipping to cellular adhesion, inflammation and hemostasis. J Hypertens 22:2087–2093CrossRef Känel R, Jain S, Mills PJ, Nelesen RA, Adler KA, Hong S et al (2004) Relation of nocturnal blood pressure dipping to cellular adhesion, inflammation and hemostasis. J Hypertens 22:2087–2093CrossRef
21.
Zurück zum Zitat Fontes-Guerra PC, Cardoso CR, Muxfeldt ES, Salles GF (2015) Nitroglycerin-mediated, but not flow-mediated vasodilation, is associated with blunted nocturnal blood pressure fall in patients with resistant hypertension. J Hypertens 33:1666–1675CrossRef Fontes-Guerra PC, Cardoso CR, Muxfeldt ES, Salles GF (2015) Nitroglycerin-mediated, but not flow-mediated vasodilation, is associated with blunted nocturnal blood pressure fall in patients with resistant hypertension. J Hypertens 33:1666–1675CrossRef
22.
Zurück zum Zitat Hamamoto K, Yamada S, Yasumoto M, Yoda M, Yoda K, Tsuda A et al (2016) Association of nocturnal hypertension with disease activity in rheumatoid arthritis. Am J Hypertens 29:340–347PubMed Hamamoto K, Yamada S, Yasumoto M, Yoda M, Yoda K, Tsuda A et al (2016) Association of nocturnal hypertension with disease activity in rheumatoid arthritis. Am J Hypertens 29:340–347PubMed
23.
Zurück zum Zitat Karakulak UN, Sahiner L, Maharjan N, Okutucu S, Evranos B, Aladag E et al (2015) Evaluation of the ambulatory arterial stiffness index in patients with rheumatoid arthritis. Blood Press Monit 20:254–259CrossRef Karakulak UN, Sahiner L, Maharjan N, Okutucu S, Evranos B, Aladag E et al (2015) Evaluation of the ambulatory arterial stiffness index in patients with rheumatoid arthritis. Blood Press Monit 20:254–259CrossRef
24.
Zurück zum Zitat Tecer D, Sezgin M, Kanık A, İncel NA, Çimen ÖB, Biçer A et al (2016) Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis? Biomark Med 10:967–974CrossRef Tecer D, Sezgin M, Kanık A, İncel NA, Çimen ÖB, Biçer A et al (2016) Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis? Biomark Med 10:967–974CrossRef
Metadaten
Titel
Nocturnal blood pressure dipping is similar in rheumatoid arthritis patients as compared to a normal population
verfasst von
O. Turgay Yildirim
E. Gonullu
F. Aydin
E. Aksit
A. Huseyinoglu Aydin
E. Dagtekin
Publikationsdatum
12.04.2018
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 2/2019
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-018-0451-4

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