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- Title
Association of Nocturnal Hypertension With Disease Activity in Rheumatoid Arthritis.
- Authors
Kae Hamamoto; Shinsuke Yamada; Mari Yasumoto; Maki Yoda; Koichiro Yoda; Akihiro Tsuda; Keiji Okamoto; Hitoshi Goto; Masaaki Inaba
- Abstract
OBJECTIVES Both nocturnal hypertension (HT) and systemic inflammation underlying rheumatoid arthritis (RA) have been shown to be independent predictors of cardiovascular disease (CVD), although little is known on the relationship between nocturnal blood pressure (BP) and disease activity in RA patients. METHODS We performed 24-hour ambulatory BP monitoring (ABPM) in 71 RA patients to examine the relationship of nocturnal fall in BP and RA disease activity based on a disease activity score of 28 joint counts with C-reactive protein (CRP, 28-joint disease activity score (DAS28)-CRP). Among them, 25 RA patients whose consent obtained were reexamined by ABPM to assess the improvement of nocturnal fall in BP after RA therapeutic intervention. RESULTS The mean DAS28-CRP level was 4.8 ± 1.6 in 71 RA patients.The mean nocturnal fall in BP was 5.6±8.9%. DAS28-CRP was associated significantly and independently in a negative manner with the nocturnal fall in BP (β = -0.388, P = 0.004). In 25 RA patients, DAS28-CRP improved from 5.4 ±1.1 to 3.5 ±0.8 (P< 0.0001) and the nocturnal fall in BP increased significantly from 4.5 ±9.2% to 10.6±5.8% (P = 0.002) with the significant decrease of nighttime systolic BP (SBP) from 121.2 ± 22.5 mm Hg to 112.5 ±18.8 mm Hg (P=0.02) in spite of no change in daytime BP after 4 weeks of RA treatment. CONCLUSIONS The present study observed that higher RA activity was associated with lower nocturnal fall in BP, but not daytime BP, in RA patients.
- Subjects
HYPERTENSION; BLOOD pressure; CARDIOVASCULAR diseases; C-reactive protein; RHEUMATOID arthritis
- Publication
American Journal of Hypertension, 2016, Vol 29, Issue 3, p340
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpv119