Blood pressure changes in patients with recent-onset rheumatoid arthritis treated with four different treatment strategies: a post hoc analysis from the BeSt trial

被引：53
作者：
Klarenbeek, Naomi B. [1 ]
van der Kooij, Sjoerd M. [1 ]
Huizinga, Tineke J. W. [1 ]
Goekoop-Ruiterman, Yvonne P. M. [1 ]
Hulsmans, Harry M. J. [2 ]
van Krugten, Michiel V. [3 ]
Speyer, Irene [4 ]
de Vries-Bouwstra, Jeska K. [1 ]
Kerstens, Pit J. S. M. [5 ]
Huizinga, Tom W. J. [1 ]
Dijkmans, Ben A. C. [5 ,6 ]
Allaart, Cornelia F. [1 ]
机构：
[1] Leiden Univ, Med Ctr, Dept Rheumatol, NL-2300 RC Leiden, Netherlands
[2] Haga Hosp, Dept Rheumatol, The Hague, Netherlands
[3] Walcheren Hosp, Dept Rheumatol, Vlissingen, Netherlands
[4] Bronovo Hosp, Dept Rheumatol, The Hague, Netherlands
[5] Jan van Breemen Inst, Dept Rheumatol, Amsterdam, Netherlands
[6] Vrije Univ Amsterdam Med Ctr, Dept Rheumatol, Amsterdam, Netherlands
来源：
ANNALS OF THE RHEUMATIC DISEASES | 2010年 / 69卷 / 07期
关键词：
CARDIOVASCULAR RISK; METHOTREXATE; THERAPY; DISEASE;
D O I：
10.1136/ard.2009.124180
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Objective To evaluate the effect of disease activity and antirheumatic treatment on blood pressure (BP) in patients with recent-onset rheumatoid arthritis (RA). Methods 508 patients with RA were randomised to receive (1) sequential monotherapy, (2) step-up combination therapy, (3) initial combination with prednisone or (4) with infliximab. Systolic and diastolic BP (SBP, DBP), disease activity score (DAS) and body mass index (BMI) were evaluated every 3 months. A linear mixed model was used to model SBP and DBP in each treatment group during year 1, adjusting for baseline BP, changes in BMI, DAS and cardiovascular medication. Results In all groups, mean SBP and DBP were lower for patients with DAS <= 2.4 than for patients with DAS >2.4. In addition, patients initially treated with infliximab (group 4) had a larger decrease in SBP and DBP over time than patients in groups 1-3. The decrease in BP was also observed in patients treated with infliximab after failure on conventional disease-modifying antirheumatic drugs in groups 1-3. The decrease in BP associated with treatment with infliximab occurred irrespective of the DAS response. Conclusion A lower DAS is associated with lower BP. An additional decrease in BP was observed in patients treated with infliximab. Further research is needed to confirm the effect of infliximab on BP.
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页码：1342 / 1345
页数：4
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