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类风湿关节炎和骨关节炎患者的动脉高血压患病率与疾病有关吗?

Is the prevalence of arterial hypertension in rheumatoid arthritis and osteoarthritis associated with disease?

机构信息

Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, Dubrava University Hospital, University of Zagreb School of Medicine, Av. G. Šuška 6, 10 040 Zagreb, Croatia.

出版信息

Rheumatol Int. 2013 May;33(5):1185-92. doi: 10.1007/s00296-012-2522-1. Epub 2012 Sep 11.

Abstract

In this study, we compare the prevalence of arterial hypertension (HT) in rheumatoid arthritis (RA) and osteoarthritis (OA) patients, exposed to high- and low-grade chronic inflammation, respectively, to assess the possible association between chronic inflammation and HT. A total of consecutive 627 RA and 352 OA patients were enrolled in this multicentric study. HT was defined as a systolic blood pressure (BP) ≥ 140 and/or diastolic BP ≥ 90 mmHg or current use of any antihypertensive drug. Overweight/obesity was defined as body mass index (BMI) ≥ 25, and patients ≥65 years were considered elderly. The prevalence of HT was higher in the OA group than in the RA group [73.3 % (95 % CI, 68.4, 77.7) and 59.5 % (95 % CI, 55.6, 68.4) P < 0.001, respectively]. When the results were adjusted for age and BMI, the HT prevalence was similar in both groups [RA 59 % (95 % CI, 55.1, 63.8) OA 60 % (95 % CI, 58.4, 65.0)]. In both groups, the prevalence of HT was higher in the elderly and those who were overweight than in the younger patients and those with a BMI < 25. Overweight (BMI ≥ 25) and age ≥65 were independent predictors of HT in multivariate logistic regression model, which showed no association between HT and the disease (RA or OA). The results indicate a robust association of age and BMI with HT prevalence in both RA and OA. The difference in HT prevalence between RA and OA is due rather to age and BMI than to the features of the disease, putting into question specific association of HT with RA.

摘要

在这项研究中,我们比较了分别暴露于高低水平慢性炎症的类风湿关节炎(RA)和骨关节炎(OA)患者中动脉高血压(HT)的患病率,以评估慢性炎症与 HT 之间的可能关联。这项多中心研究共纳入了 627 例 RA 和 352 例 OA 患者。HT 定义为收缩压(BP)≥140mmHg 和/或舒张压≥90mmHg 或正在使用任何降压药物。超重/肥胖定义为体重指数(BMI)≥25,年龄≥65 岁的患者被认为是老年人。OA 组的 HT 患病率高于 RA 组[73.3%(95%可信区间,68.4,77.7)和 59.5%(95%可信区间,55.6,68.4),P<0.001]。当调整年龄和 BMI 后,两组的 HT 患病率相似[RA 为 59%(95%可信区间,55.1,63.8),OA 为 60%(95%可信区间,58.4,65.0)]。在两组中,老年人和超重患者的 HT 患病率均高于年轻患者和 BMI<25 的患者。超重(BMI≥25)和年龄≥65 是多变量逻辑回归模型中 HT 的独立预测因素,该模型表明 HT 与疾病(RA 或 OA)之间无关联。结果表明,年龄和 BMI 与 RA 和 OA 中 HT 患病率之间存在显著关联。RA 和 OA 之间 HT 患病率的差异主要归因于年龄和 BMI,而不是疾病特征,这对 HT 与 RA 之间的特定关联提出了质疑。

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