The association of hypertension with asymptomatic cardiovascular organ damage in rheumatoid arthritis.
The association of hypertension with asymptomatic cardiovascular organ damage in patients with rheumatoid arthritis (RA) has been little studied by echocardiography.



Echocardiography was done in 134 RA patients and 102 healthy controls. Left ventricular (LV) geometry was considered abnormal if LV mass index or relative wall thickness was increased. LV diastolic dysfunction was considered present if septal early diastolic tissue velocity <8 cm/s. Systemic arterial compliance (SAC) was assessed from stroke volume index/pulse pressure ratio.



The hypertensive RA patients (n = 72) had higher inflammatory activity, older age and more diabetes than the normotensive RA patients (n = 62) (all p < 0.05). Rates of abnormal LV geometry, LV diastolic dysfunction and lower SAC were higher among the hypertensive RA patients (p < 0.05), but similar between normotensive RA patients and controls. Hypertension was associated with a 3-fold higher prevalence both for abnormal LV geometry (odds ratio 2.89 [95% confidence interval 1.09-7.63], p = 0.03) and for diastolic LV dysfunction (odds ratio 2.92 [95% confidence interval 1.14-7.46], p = 0.03) as well as lower SAC (β = 0.31, p = 0.001) independent of age, gender, diabetes and inflammatory activity measured by erythrocyte sedimentation rate.



The presence of asymptomatic cardiovascular organ damage in RA patients is closely associated with hypertension independent of inflammatory activity.
a Department of Heart Disease , Haukeland University Hospital , Bergen , Norway ;|b Department of Clinical Science , University of Bergen , Bergen , Norway ;
Helga
H
Midtbø
b Department of Clinical Science , University of Bergen , Bergen , Norway ;
Eva
E
Gerdts
c Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
Tore K
TK
Kvien
c Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
Inge C
IC
Olsen
b Department of Clinical Science , University of Bergen , Bergen , Norway ;
Mai Tone
MT
Lønnebakken
a Department of Heart Disease , Haukeland University Hospital , Bergen , Norway ;
Einar Skulstad
ES
Davidsen
c Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
Silvia
S
Rollefstad
c Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
Anne Grete
AG
Semb
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001794:Blood Pressure; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
Hypertension; left ventricular geometry; rheumatoid arthritis; systemic arterial compliance