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The following is a summary of “Blood Pressure Changes During Methotrexate Treatment: Results from a Randomized Placebo-Controlled Trial Among Patients with Cardiovascular Risk,” published in the December 2024 issue of Rheumatology by Cui et al.
Low dose methotrexate (LD-MTX) reduces cardiovascular disease (CVD) risk in patients with systemic rheumatic diseases, but its effects on the general population remain unclear.
Researchers conducted a retrospective study to examine the effect of LD-MTX on blood pressure (BP).
They examined data from a randomized double-blind controlled trial with patients having known CVD but no rheumatic disease. Systolic and diastolic BP (SBP, DBP) were measured at each scheduled study visit over 5 years. Longitudinal SBP and DBP were compared between the LD-MTX and placebo groups using a linear mixed model.
The results showed that 2,391 patients were randomized to LD-MTX and 2,395 to placebo, with a mean follow-up of 26 months. At baseline, SBP was 128 mmHg (IQR 118–139), and DBP was 74 mmHg (IQR 67–80) for both groups. About 93% of patients reported using hypertension medication. After treatment, the estimated difference in SBP change was -0.75 mmHg (95% CI -0.02 to -1.49), and in DBP was -0.56 mmHg (95% CI -0.12 to -1.01) for the LD-MTX group compared with placebo.
They found no clinically meaningful difference in BP between patients randomized to LD-MTX and those receiving a placebo.
Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae604/7918345
