Steroids Linked to Increased Hypertension in Rheumatoid arth
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Patients with RA are frequently treated with glucocorticoids (GCs), but evidence is conflicting about whether GCs are associated with hypertension. The aim of this study was to determine whether GCs are associated with incident hypertension in patients with RA.

A retrospective cohort of patients with incident RA and without hypertension was identified from UK primary care electronic medical records. GC prescriptions were used to determine time-varying GC use, dose and cumulative dose, with a 3 month attribution window. Hypertension was identified through either: blood pressure measurements greater than 140/90 mmHg, or antihypertensive prescriptions and a Read code for hypertension.

Results: There were 17760 patients in the cohort. A total of 7421 (42%) were prescribed GCs during follow-up. The incident rate of hypertension was 64.1 per 1000 person years. The Cox proportional hazards model indicated that recent GC use was associated with a 17% increased hazard of hypertension. When categorized by dose, only doses above 7.5 mg were significantly associated with hypertension. Cumulative dose did not indicate a clear pattern.

Conclusively, Recent GC use was associated with incident hypertension in patients with RA, in particular doses greater than 7.5 mg were associated with hypertension. Clinicians need to consider cardiovascular risk when prescribing GCs, and ensure blood pressure is regularly monitored and treated where necessary.

Source: https://academic.oup.com/rheumatology/article/doi/10.1093/rheumatology/keaa209/5864541
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