Ishaq Muhammad, Razzaque Salma, Shohail Fadieleh, Kumar Ajeet, Muhammad Jibran Sualeh
Department of Internal Medicine, Jinnah Medical College Hospital, Korangi, Karachi, Pakistan.
Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Curr Rheumatol Rev. 2019;15(3):242-245. doi: 10.2174/1573397114666171227211048.
To determine the frequency of new-onset hypertension in patients with Rheumatoid arthritis taking leflunomide, in comparison with methotrexate in Asian setting.
Perspective case-control study was conducted in 2014 in a tertiary care hospital located in Karachi, Pakistan. Adult patients, having rheumatoid arthritis were randomly prescribed leflunomide or methotrexate. Patients having chronic hypertension, proteinuria and chronic kidney disease were excluded. Patients were monthly followed for blood pressure and heart rate measurements. Hypertension was defined using JNC 7 criteria.
Out of 144 patients enrolled, 80 patients received Leflunomide while 64 were started on methotrexate. Mean systolic blood pressure in leflunomide group at the start and at the end of study was 108.5 and 135.4mmHg, respectively while in methotrexate group, mean systolic BP was 109.8 and 110.5 mmhg, respectively. After one year follow up, 33 out of 80 (41%) patients were receiving leflunomide had pre-hypertension or hypertension, while only 3 out of 64 patients (4.7%) were receiving methotrexate had hypertension.
Risk of developing hypertension in patient receiving Leflunomide is much higher in Asian population like Pakistan as compared to western population.
在亚洲背景下，确定服用来氟米特的类风湿关节炎患者新发高血压的发生率，并与甲氨蝶呤进行比较。
2014年在巴基斯坦卡拉奇的一家三级护理医院进行了前瞻性病例对照研究。患有类风湿关节炎的成年患者被随机处方来氟米特或甲氨蝶呤。排除患有慢性高血压、蛋白尿和慢性肾病的患者。每月对患者进行血压和心率测量。高血压采用美国国家联合委员会第7版（JNC 7）标准定义。
在纳入的144例患者中，80例患者接受来氟米特治疗，64例开始使用甲氨蝶呤治疗。来氟米特组研究开始时和结束时的平均收缩压分别为108.5mmHg和135.4mmHg，而甲氨蝶呤组的平均收缩压分别为109.8mmHg和110.5mmHg。经过一年的随访，80例接受来氟米特治疗的患者中有33例（41%）患有高血压前期或高血压，而64例接受甲氨蝶呤治疗的患者中只有3例（4.7%）患有高血压。
与西方人群相比，在巴基斯坦等亚洲人群中，接受来氟米特治疗的患者发生高血压的风险要高得多。
