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Hypertension in rheumatic diseases: prevalence, awareness, treatment, and control rates according to current hypertension guidelines

Journal of Human Hypertension volume 35, pages 419–427 (2021)Cite this article

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Abstract

Hypertension is a major modifiable risk factor for cardiovascular disease. Autoimmune rheumatic diseases confer increased cardiovascular risk, which is at least partially mediated by traditional cardiovascular risk factors. We examined the prevalence, awareness, treatment, and control rates of hypertension in a large cohort of patients with rheumatic diseases. Consecutive patients attending the Rheumatology Οutpatient Clinics were studied. Hypertension was defined by both the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines and the 2017 American College of Cardiology/American Heart Association (ACC/AHA). In a total of 622 individuals, hypertension prevalence reached 54.5% according to the 2018 ESH/ESC guideline, with the highest rates observed in patients with osteoarthritis (69.6%), rheumatoid arthritis (60.9%), and psoriatic arthritis (57.8%). Among hypertensive individuals, 21.7% were unaware of high blood pressure levels, while 67.2% were treated. Only 48.6% of treated hypertensives reached the 2018 ESC/ESH treatment goals. Applying the 2017 ACC/AHA criteria would result in a substantial increase of hypertension prevalence (72.4%) for both genders and especially among younger individuals, accompanied by a dramatic drop in control rates among treated patients (16.7%). In conclusion, comorbid hypertension was highly prevalent in a large cohort of patients with rheumatic diseases according to ESH/ESC and especially, ACC/AHA guidelines. However, it remains underdiagnosed and undertreated in a significant portion, while control rates are far from optimal. Our findings highlight the importance of systematic screening and more aggressive treatment of hypertension among patients with rheumatic diseases.

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Fig. 1: Prevalence of hypertension in different rheumatic diseases as defined by the 2018 ESC/ESH and the 2017 ACC/AHA hypertension guidelines.
Fig. 2: Prevalence of hypertension according to gender.
Fig. 3: Prevalence of hypertension in patients with rheumatic diseases stratified by age.

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Authors and Affiliations

  1. 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Panagiota Anyfanti, Eugenia Gkaliagkousi, Areti Triantafyllou, Nikolaos Koletsos, Eleni Gavriilaki & Stella Douma

  2. Rheumatology Department, Papageorgiou Hospital, Thessaloniki, Greece

    Vasiliki Galanopoulou

  3. Rheumatology Department-2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Spyros Aslanidis

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  1. Panagiota Anyfanti
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Correspondence to Panagiota Anyfanti.

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Anyfanti, P., Gkaliagkousi, E., Triantafyllou, A. et al. Hypertension in rheumatic diseases: prevalence, awareness, treatment, and control rates according to current hypertension guidelines. J Hum Hypertens 35, 419–427 (2021). https://doi.org/10.1038/s41371-020-0348-y

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