ANA and antihypertensive drugs. Any clinical importance?

ANA may occur in healthy people, particularly in older people and females and is usually unrelated to present or post medication. Their presence may be due to recent virus infections or other tissue damage. In agreement with this, ANA occur significantly more often in untreated hypertensive patients and are associated with the severity of the disorder. The ANA (and other autoantibodies) seem to be markers of an ongoing vascular injury. In agreement with this, the presence of such autoantibodies increase the five-year relative risk for cardiovascular morbidity and mortality three times, both in the general population, and in patients with essential hypertension (2). Such data emphasise the importance of careful selection of control groups whenever dealing with the ANA incidence in relation to drugs. When the patient is taking a drug recognised as being associated with increased ANA incidence, it is important to identify the drug as being one which may lead to development of SLE in ANA positive patients (Table 1). If the drug is in category A, further studies are necessary. When there are symptoms consistent with the diagnosis drug-induced SLE, discontinuation of the drug results in rapid clinical improvement if the drug is the inductive factor. Where no symptoms exist, the patient should be carefully watched if SLE develops. For drugs with a high ANA incidence, but little history of inducing SLE (category B), little more has to be done.(ABSTRACT TRUNCATED AT 250 WORDS)