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The following is a summary of “Ambulatory Blood Pressure in Patients With Rheumatoid Arthritis: Association With Immune Activation,” published in the September 2024 issue of Rheumatology by Ormseth et al.

Patients with rheumatoid arthritis (RA) have a prevalence of a cardiovascular risk factor, hypertension, due to its immune activation. 

Researchers conducted a retrospective study to determine if ambulatory 24-hour blood pressure (BP) was elevated in patients with RA compared to controls and whether it was associated with immune activation.

They conducted a study of 46 patients with RA and 23 HCs. Participants wore an ambulatory BP monitor with diurnal and nocturnal BP every 15-30 minutes. Inflammatory mediators in plasma were measured using an inflammation proteomics panel. The Mann-Whitney U test and Spearman correlation assessed differences in BP measurements and were associated with inflammatory mediators. 

The results showed a similar BP in patients with RA and controls, but median ambulatory systolic BP (SBP) measurements (24-hour [RA 121 mmHg vs. control 116 mmHg; P=0.01], diurnal [RA 128 mmHg vs control 120 mmHg; P=0.003], and nocturnal [RA 112 mmHg vs control 103 mmHg; P=0.002]) were more in patients with RA. Higher nocturnal diastolic BP (DBP; RA 63 mmHg vs. control 57 mmHg; P=0.02) was observed in patients with RA for similar DBP measurements. Nocturnal BP dipping was less in patients with RA (12%) compared to controls (16%; P=0.02). A strong correlation was examined between less nocturnal dipping and higher 24-hour and nocturnal SBPs. 

They concluded that despite similar measurements, 24-hour and nocturnal SBP was associated with inflammation and more elevated in patients with RA as compared to controls. 

Source: jrheum.org/content/51/9/870