Long-Term Exposure to Medium-Dose Glucocorticoid Therapy Associates With Hypertension in Patients With Rheumatoid Arthritis

V. F. Panoulas; K. M. J. Douglas; A. Stavropoulos-Kalinoglou; G. S. Metsios; P. Nightingale; M. D. Kita; M. S. Elisaf; G. D. Kitas


Rheumatology. 2008;47(1):72-75. 

In This Article

Patients and Methods

Recruitment and detailed characteristics of the cohort have been described in previous papers.[6] The original study had approval by the local Research Ethics Committee and Research and Development approval and all participants gave their written informed consent according to the Declaration of Helsinki.

GC dose [in all cases oral daily prednisolone (milligrams) (ODP)] and exposure time were recorded and patients were categorized using standardized nomenclature[16] into: low dose (OPD <7.5), medium dose (7.5≤ OPD ≤30) and high dose (30< OPD); short-term (<3 months), medium-term (3-6 months) or long-term (>6 months) exposure. Patients were categorized into three groups according to dose and time of GC exposure: no or limited exposure (N/L-E) (those who never received steroids or had been exposed for <3 months at the time of assessment); low-dose, long-term GC exposure (LD/LT-E) (patients who received <7.5 OPD for >6 months) and medium-dose long-term exposure (MD/LT-E) (patients on ≥7.5 OPD for >6 months). HT was defined as a systolic BP ≥140 and/or diastolic BP ≥90 and/or the use of anti-hypertensive medications.[17]

The Kolmogorov-Smirnov test was used to evaluate whether each parameter followed a normal distribution. Values were expressed as mean ± S.D., median (interquartile range) or percentages, as appropriate. Comparisons were performed by analysis of variance, Kruskal-Wallis and chi-squared test for normally distributed, non-normally distributed and categorical variables, respectively. Binary logistic regression analysis was used to evaluate the independence of the association between GC exposure and HT status. Differences were considered significant at a P-value of <0.05 (two-tailed). All analyses were carried out using SPSS 14.0 (SPSS Inc., Chicago, IL, USA).


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