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血清阳性类风湿关节炎患者与无类风湿关节炎对照者的血压趋势:一项回顾性队列研究。

Blood Pressure Trends in Patients With Seropositive Rheumatoid Arthritis Compared With Controls Without Rheumatoid Arthritis: A Retrospective Cohort Study.

作者信息

Boersma Peter, McElwee Matthew K, Hashmi Hiba, Schreiner Pamela, Demmer Ryan T, Shmagel Anna

机构信息

University of Minnesota Minneapolis.

出版信息

ACR Open Rheumatol. 2019 May 8;1(3):173-181. doi: 10.1002/acr2.1029. eCollection 2019 May.

Abstract

OBJECTIVE

Rheumatoid arthritis (RA) conveys an increased risk of cardiovascular disease (CVD), making it imperative that traditional CVD risk factors are well controlled. This study compared blood pressure (BP) trends over 13 years among patients with seropositive RA and patients without RA who received care within a large health care system in Minnesota.

METHODS

This retrospective cohort study compared 774 patients with seropositive RA and 3254 patients without RA who were matched on sex and year of birth (±5 years) and observed between 2005 and 2017. Generalized estimating equation models were used for longitudinal analyses, with adjustment for demographics, body mass index, smoking status, Charlson Comorbidity Index, number of BP measurements, and number of antihypertensive and oral glucocorticoid medications.

RESULTS

Patients both with and without RA had a mean age of 55 and were predominately female (78% with RA; 79% without RA). The mean follow-up was 6.3 (SD 3.4) years for patients with RA and 7.2 (SD 3.3) years for patients without RA. Overall, systolic BP, diastolic BP, and the number of prescribed antihypertensive medications did not differ between groups. Patients with RA were more likely to be current smokers compared with patients without RA (23% vs 11%; < 0.01) and were less likely to have serum lipid measurements (75% vs 85%; < 0.01).

CONCLUSION

BP was similarly controlled in patients with seropositive RA and patients without RA. However, diastolic BP in patients with RA was trending up in most recent years. Patients with RA were also more likely to smoke compared with controls and were less likely to have serum lipid measurements.

摘要

目的

类风湿关节炎(RA)会增加心血管疾病(CVD)的风险,因此必须对传统的CVD危险因素进行良好控制。本研究比较了血清反应阳性RA患者与在明尼苏达州一个大型医疗保健系统中接受治疗的非RA患者在13年中的血压(BP)趋势。

方法

这项回顾性队列研究比较了774例血清反应阳性RA患者和3254例非RA患者,这些患者在性别和出生年份(±5岁)上进行了匹配,并在2005年至2017年期间进行了观察。使用广义估计方程模型进行纵向分析,并对人口统计学、体重指数、吸烟状况、查尔森合并症指数、BP测量次数以及抗高血压和口服糖皮质激素药物的数量进行了调整。

结果

患有和未患RA的患者平均年龄均为55岁,且以女性为主(RA患者中78%为女性;非RA患者中79%为女性)。RA患者的平均随访时间为6.3(标准差3.4)年,非RA患者为7.2(标准差3.3)年。总体而言,两组之间的收缩压、舒张压和开具的抗高血压药物数量没有差异。与非RA患者相比,RA患者更有可能是当前吸烟者(23%对11%;P<0.01),并且进行血脂测量的可能性更小(75%对85%;P<0.01)。

结论

血清反应阳性RA患者和非RA患者的血压得到了相似的控制。然而,近年来RA患者的舒张压呈上升趋势。与对照组相比,RA患者吸烟的可能性也更大,并且进行血脂测量的可能性更小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9266/6858045/42f3d2f401e2/ACR2-1-173-g001.jpg

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