Glucocorticoids for Rheumatoid Arthritis Increase Hypertension Risk

Glucocorticoids, particularly doses of 7.5 mg or higher, are associated with increased hypertension risk among patients with rheumatoid arthritis (RA), according to a new study.

“[Glucocorticoids] are frequently prescribed in RA, with up to two-thirds of patients with RA ever prescribed [glucocorticoids],” the researchers wrote. “This reflects their powerful anti-inflammatory effects, yet their use is associated with a wide range of adverse effects.”

The retrospective study included 17,760 patients in the United Kingdom with incident RA and without hypertension at baseline. During follow-up, 42% were prescribed glucocorticoids. 

According to the study, recent glucocorticoid use was associated with a 17% increased risk of developing hypertension.

When the researchers categorized glucocorticoid use by dose, they did not find that taking less than 7.5 mg was significantly linked with hypertension. The finding suggests “low doses were less of a concern,” the authors observed, “although the point estimates were in the direction of increased risk for all categories of [glucocorticoid] dose.” 

In all, 40% of patients prescribed glucocorticoids who developed hypertension did not receive a prescription for antihypertensive medication at any point during the study. 

“Blood pressure was not frequently monitored in primary care, and a large proportion of RA patients on glucocorticoids with high blood pressure readings were untreated,” the researchers wrote. “Given that patients with RA are already at increased risk of cardiovascular disease, it is important that these patients should have their blood pressure checked regularly and treated appropriately.”

—Jolynn Tumolo

Reference:

Costello RE, Yimer BB, Roads P, Jani M, Dixon WG. Glucocorticoid use is associated with an increased risk of hypertension. Rheumatology. 2021;60(1):132-139. doi:10.1093/rheumatology/keaa209