Effect of hypertension on echocardiographic parameters in rheumatoid arthritis

Zeitschrift für Rheumatologie - Tập 73 - Trang 934-938 - 2014
A. Temiz1, S. Özcan2, F. Gökmen3, E. Gazi1, A. Barutcu1, A. Bekler1, B. Altun1, A. Akbal3, F. Güneş4, H. Şen4
1Department of Cardiology, School of Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey
2Cardiovascular Surgery, Çanakkale 18 Mart University, Çanakkale, Turkey
3Department of Physical Medicine and Rehabilitation, Çanakkale 18 Mart University, Çanakkale, Turkey
4Department of Internal Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey

Tóm tắt

Hypertension (HTN) is common in rheumatoid arthritis (RA) patients. Both HTN and RA have a negative impact on echocardiographically determined parameters including wall thickness, chamber diameter, diastolic function, epicardial adipose tissue (EAT) and carotid intima media thickness (CIMT). We aimed to demonstrate the effect of HTN on these parameters in RA patients. Patients were divided into two groups: one group comprised 39 RA patients with HTN (7 male, mean age 56.3 ± 8.4 years) and the second comprised 38 age- and gender-matched RA patients without HTN (10 male, mean age 55.3 ± 7.4 years). We retrospectively analyzed the RA patients without overt structural heart disease by determining the study parameters from echocardiograph recordings. The two groups were compared in terms of echocardiographic parameters and disease characteristics. RA characteristics, chamber sizes and wall thicknesses did not differ between the groups. CIMT was significantly increased in the RA with HTN group (median 0.9 mm, range 0.6–1.2 mm vs. median 0.8 mm, range 0.6–1.0 mm; p = 0.031). EAT was also significantly increased in the RA with HTN group (8.2 ± 1.8 mm vs. 7.4 ± 1.4 mm; p = 0.022). Septal early diastolic E’ wave velocities were significantly decreased in the RA with HTN group (8.8 ± 2.4 cm/s vs. 10.2 ± 1.8 cm/s; p = 0.016). HTN has a further negative impact on diastolic functions, CIMT and EAT in RA patients.

Tài liệu tham khảo

Lawrence RC, Helmick CG, Arnett FC et al (1998) Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 41:778–799 Solomon DH, Karlson EW, Rimm EB et al (2003) Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 107:1303–1307 Crowson CS, Liao KP, Davis JM III et al (2013)Rheumatoid arthritis and cardiovascular disease. Am Heart J doi:10.1016/j.ahj.2013.07.010 Aviña-Zubieta JA, Choi HK, Sadatsafavi M et al (2008) Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum 59:1690–1697 Van Doornum S, McColl G, Wicks IP (2002) Accelerated atherosclerosis: an extraarticular feature of rheumatoid arthritis? Arthritis Rheum 46:862–873 Ozbalkan Z, Efe C, Cesur M et al (2010) An update on the relationships between rheumatoid arthritis and atherosclerosis. Atherosclerosis 212:377–382 Del Rincón I, O’Leary DH, Freeman GL, Escalante A (2007) Acceleration of atherosclerosis during the course of rheumatoid arthritis. Atherosclerosis 195:354–360 Gonzalez-Gay MA, Gonzalez-Juanatey C, Vazquez-Rodriguez TR et al (2008) Endothelial dysfunction, carotid intima-media thickness, and accelerated atherosclerosis in rheumatoid arthritis. Semin Arthritis Rheum 38:67–70 Rodríguez-Rodríguez L, López-Mejías R, García-Bermúdez M et al (2012) Genetic markers of cardiovascular disease in rheumatoid arthritis. Mediators Inflamm. doi:10.1155/2012/574817 Cavagna L, Boffini N, Cagnotto G et al (2012) Atherosclerosis and rheumatoid arthritis: more than a simple association. Mediators Inflamm. doi:10.1155/2012/147354 Yusuf S, Hawken S, Ounpuu S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364:937–952 Panoulas VF, Metsios GS, Pace AV et al (2008) Hypertension in rheumatoid arthritis. Rheumatology (Oxford) 47:1286–1298 Protogerou AD, Panagiotakos DB, Zampeli E et al (2013) Arterial hypertension assessed “out-of-office” in a contemporary cohort of rheumatoid arthritis patients free of cardiovascular disease is characterized by high prevalence, low awareness, poor control and increased vascular damage-associated “white coat” phenomenon. Arthritis Res Ther. doi:10.1186/ar4324 Panoulas VF, Douglas KM, Milionis HJ et al (2007) Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis. Rheumatology (Oxford) 46:1477–1482 Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324 Ikeda N, Sapienza D, Guerrero R et al (2014) Control of hypertension with medication: a comparative analysis of national surveys in 20 countries. Bull World Health Organ 92:10–19C Fields LE, Burt VL, Cutler JA et al (2004) The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension 44:398–404 Altun B, Arici M, Nergizoğlu G et al (2005) Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens 23:1817–1823 Khatib R, Schwalm JD, Yusuf S et al (2014) Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies. PLoS One. doi:10.1371/journal.pone.0084238 Higashi Y, Kihara Y, Noma K (2012) Endothelial dysfunction and hypertension in aging. Hypertens Res 35:1039–1047 O’Rourke MF, Nichols WW (2005) Aortic diameter, aortic stiffness, and wave reflection increase with age and isolated systolic hypertension. Hypertension 45:652–658 Gaasch WH, Zile MR (2013) Left ventricular structural remodeling in health and disease: with special emphasis on volume, mass, and geometry. J Am Coll Cardiol 58:1733–1740 Schmieder RE, Messerli FH (2000) Hypertension and the heart. J Hum Hypertens 14:597–604 Vaziri SM, Larson MG, Lauer MS et al (1995) Influence of blood pressure on left atrial size. The Framingham Heart Study. Hypertension 25:1155–1160 Eroğlu S, Sade LE, Yıldırır A et al (2013) Association of epicardial adipose tissue thickness by echocardiography and hypertension. Turk Kardiyol Dern Ars 41:115–122 Çetin M, Kocaman SA, Durakoğlugil ME et al (2013) Effect of epicardial adipose tissue on diastolic functions and left atrial dimension in untreated hypertensive patients with normal systolic function. J Cardiol 61:359–364 Kocaman SA, Durakoğlugil ME, Çetin M et al (2013) The independent relationship of epicardial adipose tissue with carotid intima-media thickness and endothelial functions: the association of pulse wave velocity with the active facilitated arterial conduction concept. Blood Press Monit 18:85–93 Dicker D, Atar E, Kornowski R, Bachar GN (2013) Increased epicardial adipose tissue thickness as a predictor for hypertension: a cross-sectional observational study. J Clin Hypertens (Greenwich) 15:893–898 Hughes AD, Sinclair AM, Geroulakos G et al (1993) Structural changes in the heart and carotid arteries associated with hypertension in humans. J Hum Hypertens 7:395–397 Vaudo G, Marchesi S, Gerli R et al (2004) Endothelial dysfunction in young patients with rheumatoid arthritis and low disease activity. Ann Rheum Dis 63:31–35 Chatterjee Adhikari M, Guin A, Chakraborty S et al (2012) Subclinical atherosclerosis and endothelial dysfunction in patients with early rheumatoid arthritis as evidenced by measurement of carotid intima-media thickness and flow-mediated vasodilatation: an observational study. Semin Arthritis Rheum 41:669–675 Pieringer H, Brummaier T, Schmid M et al (2012) Rheumatoid arthritis is an independent risk factor for an increased augmentation index regardless of the coexistence of traditional cardiovascular risk factors. Semin Arthritis Rheum 42:17–22 Crilly MA, Kumar V, Clark HJ et al (2009) Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis: a dose-response relationship independent of established cardiovascular risk factors. Rheumatology (Oxford) 48:1606–1612 Yazici D, Tokay S, Aydin S et al (2008) Echocardiographic evaluation of cardiac diastolic function in patients with rheumatoid arthritis: 5 years of follow-up. Clin Rheumatol 27:647–650 Rudominer RL, Roman MJ, Devereux RB et al (2009) Independent association of rheumatoid arthritis with increased left ventricular mass but not with reduced ejection fraction. Arthritis Rheum 60:22–29 Ormseth MJ, Lipson A, Alexopoulos N et al (2013) Association of epicardial adipose tissue with cardiometabolic risk and metabolic syndrome in patients with rheumatoid arthritis. Arthritis Care Res (Hoboken) 65:1410–1415 Sijl AM van, Peters MJ, Knol DK et al (2011) Carotid intima media thickness in rheumatoid arthritis as compared to control subjects: a meta-analysis. Semin Arthritis Rheum 40:389–397 Schiffrin EL (2014) Inflammation, immunity and development of essential hypertension. J Hypertens 32:228–229 Iacobellis G, Bianco AC (2011) Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features. Trends Endocrinol Metab 22:450–457 D’Marco LG, Bellasi A, Kim S et al (2013) Epicardial adipose tissue predicts mortality in incident hemodialysis patients: a substudy of the Renagel in New Dialysis trial. Nephrol Dial Transplant 28:2586–2595