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

Ähnlicher nächtlicher Blutdruckabfall bei Patienten mit rheumatoider Arthritis wie in der Normalbevölkerung

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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.

Zusammenfassung

Ziel

Die rheumatoide Arthritis (RA) ist eine systemische entzündliche Autoimmunerkrankung, durch welche sich überdies das Risiko einer Herz-Kreislauf-Krankheit verdoppelt. In einigen Studien finden sich Hinweise, dass bei RA-Patienten die Prävalenz der Hypertonie aufgrund von Prednisolontherapie, klinischem Zustand, genetischen Faktoren und körperlicher Inaktivität zunimmt. Andererseits ist der Blutdruckabfall bei RA-Patienten im Vergleich zu Probanden ohne RA nach Wissen der Autoren bisher nicht untersucht worden. Ziel der Studie war es zu untersuchen, ob bei RA-Patienten der Zustand ohne Blutdruckabfall schlechter ist.

Methoden

In der vorliegenden Querschnittstudie wurden 65 RA-Patienten und 61 in Alter und Geschlecht entsprechend ausgewählte Kontrollen untersucht. Die Patienten wurden nach den Ergebnissen ihrer ambulanten 24-h-Blutdruckmessung eingeteilt. Dabei wurden Patienten mit vorangehender Diagnose einer Hypertonie, koronaren Herzkrankheit oder mit auffälliger Nierenfunktion aus der Studie ausgeschlossen.

Ergebnisse

Das Durchschnittsalter der Stichprobe betrug 53,7 ± 12,3 Jahre, 40,5% der Teilnehmer waren männlich. Es bestand kein signifikanter Unterschied zwischen den Gruppen in Bezug auf grundlegende demographische Merkmale; Leukozytenzahl (p = 0,001), Neutrophilenzahl (p = 0,001) und Erythrozytenverteilungsbreite (p = 0,000) waren jedoch in der RA-Gruppe signifikant höher. Die Ergebnisse der ambulanten Blutdruckmessung zeigten keinen signifikanten Unterschied zwischen RA-Patienten und der Kontrollgruppe hinsichtlich des systolischen und diastolischen Blutdrucks am Tag und in der Nacht sowie den durchschnittlichen Ergebnissen für den systolischen und diastolischen Blutdruck (p > 0,05). Es gab keinen statistischen Unterschied beim Zustand ohne Blutdruckabfall zwischen den Patientengruppen (p = 0,412). Der nächtliche Blutdruckabfall war bei den Gruppen in signifikanter Weise ähnlich (p = 0,980).

Schlussfolgerung

RA-Patienten weisen ähnliche Werte wie die Normalbevölkerung auf in Bezug auf nächtlichen Blutdruckabfall und die Diagnose einer Hypertonie.

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Authors and Affiliations

  1. Cardiology Department, Eskişehir State Hospital, Eskişehir, Turkey

    O. Turgay Yildirim, F. Aydin, A. Huseyinoglu Aydin & E. Dagtekin

  2. Rheumatology Department, Eskişehir State Hospital, Eskişehir, Turkey

    E. Gonullu

  3. Cardiology Department, Canakkale Onsekiz Mart University, Canakkale, Turkey

    E. Aksit

Authors
  1. O. Turgay Yildirim
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  2. E. Gonullu
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  3. F. Aydin
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  4. E. Aksit
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  5. A. Huseyinoglu Aydin
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  6. E. Dagtekin
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Correspondence to O. Turgay Yildirim.

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Conflict of interest

O. Turgay Yildirim, E. Gonullu, F. Aydin, E. Aksit, A. Huseyinoglu Aydin, and E. Dagtekin declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Turgay Yildirim, O., Gonullu, E., Aydin, F. et al. Nocturnal blood pressure dipping is similar in rheumatoid arthritis patients as compared to a normal population. Z Rheumatol 78, 190–194 (2019). https://doi.org/10.1007/s00393-018-0451-4

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