Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Impact of hypertension on vascular remodeling in patients with psoriatic arthritis

Journal of Human Hypertension volume 28, pages 105–110 (2014)Cite this article

Subjects

Abstract

We studied the impact of hypertension along with traditional and new cardiovascular risk factors on the structural and functional properties of arteries in psoriatic arthritis (PsA) patients. We examined 42 PsA subjects (aged 51±9 years) stratified according to hypertensive status (19 normotensive, PsA-NT and 23 hypertensives, PsA-HT). Thirty-eight normotensive subjects (C-NT) and 23 hypertensives (C-HT) comparable by age and sex served as controls. Mean carotid intima-media thickness (mean-IMT) and mean of the maximum IMT (M-Max) were evaluated by ultrasound in carotid artery segment bilaterally. Post-occlusion flow-mediated dilation (FMD) of the brachial artery was evaluated by ultrasonography. These parameters were correlated with risk factors, markers of inflammation and disease activity. Values of mean-IMT were higher in both groups of PsA patients compared with C-NT (0.68 mm in PsA-NT and 0.75 mm in PsA-HT versus 0.61 mm in C-NT). PsA-HT displayed higher M-Max (0.95 mm) versus both C-HT (0.71 mm) and PsA-NT (0.79 mm). FMD was impaired in PsA subjects compared with C-NT (5.7% in PsA-NT and 6.0% PsA-HT versus 9.3% in C-NT), whereas there was no difference among PsA-HT, PsA-NT, and C-HT groups. Values of carotid IMT were directly related to tumor necrosis factor (TNF)-α, osteoprotegerin (OPG), blood pressure and lipid profile levels. FMD showed an inverse relationship with TNF-α and blood pressure, but no correlation with lipids. In conclusion, PsA per se implies a pro-atherogenic remodeling, which is enhanced by the hypertensive status. TNF-α and OPG may have an independent role in the development of such vascular damage.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Shoenfeld Y, Gerli R, Doria A, Matsuura E, Cerinic MM, Ronda N et al. Accelerated atherosclerosis in autoimmune rheumatic diseases. Circulation 2005; 112 (21): 3337–3347.

    Article  Google Scholar 

  2. Doria A, Sherer Y, Meroni PL, Shoenfeld Y . Inflammation and accelerated atherosclerosis: basic mechanisms. Rheum Dis Clin North Am 2005; 31 (2): 355–362 viii.

    Article  Google Scholar 

  3. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H . Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54 (8): 2665–2673.

    Article  Google Scholar 

  4. Gonzalez-Juanatey C, Llorca J, Amigo-Diaz E, Dierssen T, Martin J, Gonzalez-Gay MA . High prevalence of subclinical atherosclerosis in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors. Arthritis Rheum 2007; 57 (6): 1074–1080.

    Article  Google Scholar 

  5. Eder L, Zisman D, Barzilai M, Laor A, Rahat M, Rozenbaum M et al. Subclinical atherosclerosis in psoriatic arthritis: a case-control study. J Rheumatol 2008; 35 (5): 877–882.

    PubMed  Google Scholar 

  6. Di Minno MN, Iervolino S, Peluso R, Scarpa R, Di Minno G . Carotid intima-media thickness in psoriatic arthritis: differences between tumor necrosis factor-alpha blockers and traditional disease-modifying antirheumatic drugs. Arterioscler Thromb Vasc Biol 2011; 31 (3): 705–712.

    Article  CAS  Google Scholar 

  7. Troitzsch P, Paulista Markus MR, Dorr M, Felix SB, Junger M, Schminke U et al. Psoriasis is associated with increased intima-media thickness—the Study of Health in Pomerania (SHIP). Atherosclerosis 2012; 225 (2): 486–490.

    Article  CAS  Google Scholar 

  8. Hansson GK . Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005; 352 (16): 1685–1695.

    Article  CAS  Google Scholar 

  9. Kiechl S, Werner P, Knoflach M, Furtner M, Willeit J, Schett G . The osteoprotegerin/RANK/RANKL system: a bone key to vascular disease. Expert Rev Cardiovasc Ther 2006; 4 (6): 801–811.

    Article  CAS  Google Scholar 

  10. Fadini GP, Rattazzi M, Matsumoto T, Asahara T, Khosla S . Emerging role of circulating calcifying cells in the bone-vascular axis. Circulation 2012; 125 (22): 2772–2781.

    Article  Google Scholar 

  11. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Desvarieux M et al. Mannheim intima-media thickness consensus. Cerebrovasc Dis. 2004; 18 (4): 346–349.

    Article  Google Scholar 

  12. Deanfield J, Donald A, Ferri C, Giannattasio C, Halcox J, Halligan S et al. Endothelial function and dysfunction. Part I: Methodological issues for assessment in the different vascular beds: a statement by the Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension. J Hypertens 2005; 23 (1): 7–17.

    Article  CAS  Google Scholar 

  13. Mease PJ, Antoni CE, Gladman DD, Taylor WJ . Psoriatic arthritis assessment tools in clinical trials. Ann Rheum Dis. 2005; 64 (Suppl 2:ii): 49–54.

  14. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G et al2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC task force on the management of arterial hypertension. J Hypertens 2007; 25 (9): 1751–1762.

    Article  CAS  Google Scholar 

  15. Puato M, Palatini P, Zanardo M, Dorigatti F, Tirrito C, Rattazzi M et al. Increase in carotid intima-media thickness in grade I hypertensive subjects: white-coat versus sustained hypertension. Hypertension 2008; 51 (5): 1300–1305.

    Article  CAS  Google Scholar 

  16. Gemignani V, Faita F, Ghiadoni L, Poggianti E, Demi M . A system for real-time measurement of the brachial artery diameter in B-mode ultrasound images. IEEE Trans Med Imaging 2007; 26 (3): 393–404.

    Article  Google Scholar 

  17. Ghiadoni L, Faita F, Salvetti M, Cordiano C, Biggi A, Puato M et al. Assessment of flow-mediated dilation reproducibility: a nationwide multicenter study. J Hypertens 2012; 30 (7): 1399–1405.

    Article  CAS  Google Scholar 

  18. Ramonda R, Lo Nigro A, Modesti V, Nalotto L, Musacchio E, Iaccarino L et al. Atherosclerosis in psoriatic arthritis. Autoimmun Rev. 2011; 10 (12): 773–778.

    Article  CAS  Google Scholar 

  19. Riccioni G, Back M, Capra V . Leukotrienes and atherosclerosis. Curr Drug Targets. 2010; 11 (7): 882–887.

    Article  CAS  Google Scholar 

  20. Iversen L, Kragballe K, Ziboh VA . Significance of leukotriene-A4 hydrolase in the pathogenesis of psoriasis. Skin Pharmacol 1997; 10 (4): 169–177.

    Article  CAS  Google Scholar 

  21. Gonzalez-Juanatey C, Llorca J, Miranda-Filloy JA, Amigo-Diaz E, Testa A, Garcia-Porrua C et al. Endothelial dysfunction in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors. Arthritis Rheum 2007; 57 (2): 287–293.

    Article  CAS  Google Scholar 

  22. Pauletto P, Palatini P, Da Ros S, Pagliara V, Santipolo N, Baccillieri S et al. Factors underlying the increase in carotid intima-media thickness in borderline hypertensives. Arterioscler Thromb Vasc Biol 1999; 19 (5): 1231–1237.

    Article  CAS  Google Scholar 

  23. Versari D, Daghini E, Virdis A, Ghiadoni L, Taddei S . Endothelium-dependent contractions and endothelial dysfunction in human hypertension. Br J Pharmacol 2009; 157 (4): 527–536.

    Article  CAS  Google Scholar 

  24. Skoog T, Dichtl W, Boquist S, Skoglund-Andersson C, Karpe F, Tang R et al. Plasma tumour necrosis factor-alpha and early carotid atherosclerosis in healthy middle-aged men. Eur Heart J. 2002; 23 (5): 376–383.

    Article  CAS  Google Scholar 

  25. Ridker PM, Rifai N, Pfeffer M, Sacks F, Lepage S, Braunwald E . Elevation of tumor necrosis factor-alpha and increased risk of recurrent coronary events after myocardial infarction. Circulation 2000; 101 (18): 2149–2153.

    Article  CAS  Google Scholar 

  26. Zhang H, Park Y, Wu J, Chen X, Lee S, Yang J et al. Role of TNF-alpha in vascular dysfunction. Clin Sci (Lond) 2009; 116 (3): 219–230.

    Article  CAS  Google Scholar 

  27. Vik A, Mathiesen EB, Brox J, Wilsgaard T, Njolstad I, Jorgensen L et al. Relation between serum osteoprotegerin and carotid intima media thickness in a general population - the Tromso Study. J Thromb Haemost 2010; 8 (10): 2133–2139.

    Article  CAS  Google Scholar 

  28. Asanuma Y, Chung CP, Oeser A, Solus JF, Avalos I, Gebretsadik T et al. Serum osteoprotegerin is increased and independently associated with coronary-artery atherosclerosis in patients with rheumatoid arthritis. Atherosclerosis 2007; 195 (2): e135–e141.

    Article  CAS  Google Scholar 

  29. Chandran V, Cook RJ, Edwin J, Shen H, Pellett FJ, Shanmugarajah S et al. Soluble biomarkers differentiate patients with psoriatic arthritis from those with psoriasis without arthritis. Rheumatology (Oxford) 2010; 49 (7): 1399–1405.

    Article  CAS  Google Scholar 

  30. Griffiths CE, Iaccarino L, Naldi L, Olivieri I, Pipitone N, Salvarani C et al. Psoriasis and psoriatic arthritis: immunological aspects and therapeutic guidelines. Clin Exp Rheumatol 2006; 24 (1 Suppl 40): S72–S78.

    CAS  PubMed  Google Scholar 

  31. Zannettino AC, Holding CA, Diamond P, Atkins GJ, Kostakis P, Farrugia A et al. Osteoprotegerin (OPG) is localized to the Weibel-Palade bodies of human vascular endothelial cells and is physically associated with von Willebrand factor. J Cell Physiol 2005; 204 (2): 714–723.

    Article  CAS  Google Scholar 

  32. Ovchinnikova O, Gylfe A, Bailey L, Nordstrom A, Rudling M, Jung C et al. Osteoprotegerin promotes fibrous cap formation in atherosclerotic lesions of ApoE-deficient mice—brief report. Arterioscler Thromb Vasc Biol 2009; 29 (10): 1478–1480.

    Article  CAS  Google Scholar 

  33. Puato M, Faggin E, Rattazzi M, Paterni M, Kozakova M, Palombo C et al. In vivo noninvasive identification of cell composition of intimal lesions: a combined approach with ultrasonography and immunocytochemistry. J Vasc Surg 2003; 38 (6): 1390–1395.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the Biomedical Foundation for Cardiovascular Research and Gene Therapy of Padova, Italy, (a no-profit Institution) for financial support to this study. This work was also supported by the University of Padova (CPDA083710/08 to MR).

Author information

Author notes

  1. M Puato and R Ramonda: These authors contributed equally to this study.

Authors and Affiliations

  1. Department of Medicine DMED, Clinica Medica 4, University of Padova, Padova, Italy

    M Puato, E Faggin, G Balbi, M Zanon, M Zanardo & C Tirrito

  2. Department of Medicine DMED, Reumatology Unit, University of Padova, Padova, Italy

    R Ramonda, A Doria, M Lorenzin, V Modesti & L Punzi

  3. Medicina Interna I, Treviso, Italy

    M Rattazzi & P Pauletto

  4. Department of Laboratory Medicine, University of Padova, Padova, Italy

    M Plebani & M Zaninotto

Authors
  1. M Puato
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R Ramonda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Doria
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Rattazzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E Faggin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G Balbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M Zanon
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M Zanardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C Tirrito
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M Lorenzin
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. V Modesti
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. M Plebani
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. M Zaninotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. L Punzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. P Pauletto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P Pauletto.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on the Journal of Human Hypertension website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Puato, M., Ramonda, R., Doria, A. et al. Impact of hypertension on vascular remodeling in patients with psoriatic arthritis. J Hum Hypertens 28, 105–110 (2014). https://doi.org/10.1038/jhh.2013.62

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2013.62

Keywords

This article is cited by

Search

Advanced search

Quick links