Glucocorticoid Use Increases Hypertension Risk in Patients With Rheumatoid Arthritis

Sarfaroj Khan 

July 07, 2020

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.

 

Costello RE, Yimer BB, Roads P, Jani M, Dixon WG. Glucocorticoid use is associated with an increased risk of hypertension. Rheumatology (Oxford). 2020 Jun 27 [Epub ahead of print]. doi: 10.1093/rheumatology/keaa209. PMID: 32596721 Abstract.

This clinical summary first appeared on Univadis, part of the Medscape Professional Network.

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