POS0534 THE PREVALENCE OF HYPERTENSION AND ITS POTENTIAL ASSOCIATED FACTORS IN CHINESE PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Y. W. Zou, C. Chen, J. Lin, J. D. Ma, Y. Y. Zou, L. Dai
Journal: Annals of the Rheumatic Diseases (2021)

Background: Cardiovascular disease (CVD) is the leading cause of mortality in patients with rheumatoid arthritis (RA), and hypertension is a modifiable risk-factor for CVD. In addition, comorbidities may shorten the life span of RA patients, which appears to be the consequence of an increased prevalence of CVD. RA patients with comorbidities might not be given the equal treatment in daily practice compared with patients without comorbidities. Objectives: To investigate the prevalence of hypertension and its associated factors in Chinese RA patients. Methods: Consecutive patients with RA were recruited from August 2015 to September 2019 at Department of Rheumatology, Sun Yat-sen Memorial Hospital. Demographic and clinical characteristics were collected including indicators of disease activity, functional assessment and radiographic assessment and CV-related comorbidities. Results: There were 674 RA patients recruited with 82.3% female and mean age 49.9±13.0 years. The prevalence rate of hypertension in RA patients was 32.9%, followed by dyslipidemia (9.9%), type 2 diabetes (8.8%), hyperuricemia (8.5%), fatty liver disease (8.0%), CVD (6.2%) and chronic kidney disease (3.3%). The prevalence of hypertension was 38.7% and 31.7% in male and female RA patients respectively ( P = 0.144). Further age stratification showed no hypertension in RA patients at 16-19 years, 2.0% at 20-29 years and 8.1% at 30-39 years. The prevalence of hypertension greatly increased after 40 years old with 24.5%, 38.6%, 54.9%, and 63.6% in RA patients of 40-49, 50-59, 60-69, ≥ 70 years old respectively, and there was no significant difference between male and female RA patients of different age (Figure 1). Compared with those without hypertension, RA patients with hypertension had advanced age (57.3 ± 9.3 years vs. 46.3 ± 13.0 years), long-standing disease duration (median 60 months vs. 48 months), higher disease activity indicators [including PtGA (median 4 vs. 3), PrGA (median 3 vs. 3) and ESR (median 33 mm/h vs. 27 mm/h)], higher functional indicator [HAQ-DI (median 0.25 vs. 0.13)], worse joint destruction [JE subscore (median 10 vs. 6)] and higher proportions of comorbidities [including type 2 diabetes (14.9% vs. 5.8%), hyperuricemia (13.1% vs. 6.1%), chronic kidney disease (6.3% vs. 1.8%), dyslipidemia (15.8% vs. 7.1%), CVD (10.4% vs. 4.2%) and fatty liver disease (13.5% vs. 5.3%), all P &lt; 0.005]. Multivariate logistic regression analysis showed that comorbidities including hyperuricemia ( OR = 1.977, 95% CI : 1.002-3.900), dyslipidemia ( OR = 1.903, 95% CI : 1.102-3.288) and fatty liver disease ( OR = 2.335, 95% CI : 1.278-4.265) were associated factors of hypertension after adjustment for age and gender Figure 1. The prevalence of hypertension in different age and sex groups of RA patients. Conclusion: Hypertension is the most common CV-related comorbidity in Chinese RA patients which is associated with hyperuricemia, dyslipidemia and fatty liver disease. Detection and management of hypertension and other CV-related comorbidities in RA patients should be emphasized. Fund program: National Natural Science Foundation of China (81801605, 81801606, 81971527); Guangdong Natural Science Foundation (2018A030313541, 2018A030313690, 2019A1515011928); Guangzhou Science and Technology Program (201904010088); Guangdong Basic and Applied Basic Research Foundation (2020A1515110061); Guangdong Medical Scientific Research Foundation (A2018062) Disclosure of Interests: None declared