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Rheumatology Advance Access first published online on May 8, 2008
This version published online on May 29, 2008
Rheumatology, doi:10.1093/rheumatology/ken159
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

Hypertension in rheumatoid arthritis

V. F. Panoulas1,2, G. S. Metsios1, A. V. Pace1, H. John1, G. J. Treharne1,3, M. J. Banks4 and G. D. Kitas1,5

1Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, UK, 2Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece, 3Department of Psychology, University of Otago, Dunedin, New Zealand, 4Department of Cardiology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley and 5ARC Epidemiology Unit, Manchester University, Manchester, UK.

Correspondence to: G. D. Kitas, Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Pensnett Road, Dudley, West Midlands DY1 2HQ, UK. E-mail: gd.kitas{at}dgoh.nhs.uk; g.d.kitas{at}bham.ac.uk


  Abstract

RA associates with an increased burden of cardiovascular disease, which is at least partially attributed to classical risk factors such as hypertension (HT) and dyslipidaemia. HT is highly prevalent, and seems to be under-diagnosed and under-treated among patients with RA. In this review, we discuss the mechanisms that may lead to increased blood pressure in such patients, paying particular attention to commonly used drugs for the treatment of RA. We also suggest screening strategies and management algorithms for HT, specific to the RA population, although it is clear that these need to be formally assessed in prospective randomized controlled trials designed specifically for the purpose, which, unfortunately, are currently lacking.

KEY WORDS: Systematic review, Rheumatoid arthritis, Cardiovascular, Hypertension, Inflammation, Physical inactivity, Medication, Non-steroidal anti-inflammatory drugs, Recommendations, Glucocorticosteroids

Submitted 2 August 2007; revised version accepted 31 March 2008.
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