Current views on the diagnosisand treatment of hypertension in patients withrheumatoid arthritis
https://doi.org/10.18705/1607-419X-2010--5-
Abstract
The article reviews the data on the frequency and the role of hypertension (HT) in the pathogenesis of cardiovascular diseases in rheumatoid arthritis (RA). Most studies indicate high frequency of HT in patients with RA that is associated with extraarticular manifestations, target organ damage. HT development is implemented through angiotensin-aldosterone system, simpatoadrenal system and is supported by endothelial dysfunction. The morphological characteristics of HT in RA patients and correlation of endothelial dysfunction with inflammation in RA are identified. Short-term anti-inflammatory therapy does not affect vascular function in RA, while longer and, in particular, therapy with tumor necrosis factor-alpha (TNF-alpha) or antimalarial drugs reduce the frequency of cardiovascular complications associated with RA. Treatment with non-steroidal anti-inflammatory drugs, leflunomide, cyclosporine, glucocorticoids is associated with the increased HT rate, which requires close monitoring of patients. We discuss the need for revision of the antihypertensive treatment and blood pressure control in RA patients, taking into account the particularities of hypertension and the severity of potential cardiovascular complications.
About the Author
A. N. Bazhenov
Almazov Federal Heart, Blood and Endocrinology Centre, St Petersburg
Russian Federation
Russian Federation
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For citations:
Bazhenov A.N. Current views on the diagnosisand treatment of hypertension in patients withrheumatoid arthritis. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2010;16(5):491-497. (In Russ.) https://doi.org/10.18705/1607-419X-2010--5-
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