title: Association of Nocturnal Hypertension With Disease Activity in Rheumatoid Arthritis.
abstract: OBJECTIVE
  Both nocturnal hypertension (HT) and systemic inflammation underlying rheumatoid arthritis (RA) have been shown to be independent predictors of cardiovascular disease (CVD), although little is known on the relationship between nocturnal blood pressure (BP) and disease activity in RA patients.
  
  
  METHODS
  We performed 24-hour ambulatory BP monitoring (ABPM) in 71 RA patients to examine the relationship of nocturnal fall in BP and RA disease activity based on a disease activity score of 28 joint counts with C-reactive protein (CRP, 28-joint disease activity score (DAS28)-CRP). Among them, 25 RA patients whose consent obtained were reexamined by ABPM to assess the improvement of nocturnal fall in BP after RA therapeutic intervention.
  
  
  RESULTS
  The mean DAS28-CRP level was 4.8±1.6 in 71 RA patients. The mean nocturnal fall in BP was 5.6±8.9%. DAS28-CRP was associated significantly and independently in a negative manner with the nocturnal fall in BP (β = -0.388, P = 0.004). In 25 RA patients, DAS28-CRP improved from 5.4±1.1 to 3.5±0.8 (P < 0.0001) and the nocturnal fall in BP increased significantly from 4.5±9.2% to 10.6±5.8% (P = 0.002) with the significant decrease of nighttime systolic BP (SBP) from 121.2±22.5mm Hg to 112.5±18.8mm Hg (P = 0.02) in spite of no change in daytime BP after 4 weeks of RA treatment.
  
  
  CONCLUSIONS
  The present study observed that higher RA activity was associated with lower nocturnal fall in BP, but not daytime BP, in RA patients.
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kae
authors.initials: K
authors.lastname: Hamamoto
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. m1265626@med.osaka-cu.ac.jp.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Yasumoto
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Yoda
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yoda
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tsuda
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology; D018660:Blood Pressure Monitoring, Ambulatory; D002097:C-Reactive Protein / Q000276:immunology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D002097:C-Reactive Protein
keywords: RA disease activity.; atherosclerosis; blood pressure; cardiovascular disease; hypertension; nocturnal HT; nocturnal fall in BP