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27-09-2019 | Rheumatology | News | Article

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Continuous NSAID use linked to hypertension risk in ankylosing spondylitis

medwireNews: Individuals with ankylosing spondylitis (AS) who continually use nonsteroidal anti-inflammatory drugs (NSAIDs) have an increased risk for hypertension relative to those who use the drugs less frequently, study findings indicate.

Writing in Arthritis Care & Research, Jean Liew (University of Washington, Seattle, USA) and co-authors say their data “support the hypothesis that NSAID use has negative effects on an important cardiovascular [CV] risk factor in a population that is known to be at-risk for cardiovascular disease.”

The analysis included 628 members of the Prospective Study of Outcomes in AS cohort (mean age 39 years, 72% men) who had no hypertension at baseline.

At baseline, 31.8% of participants reported continuous NSAID use, defined as at least 50% of the maximum recommended dose, taken daily.

During a median 7 years of follow-up, 20.5% of participants developed incident hypertension, defined as patient‐reported hypertension, antihypertensive medication use, two consecutive systolic blood pressure measurements of at least 140 mmHg, or two consecutive diastolic measurements of at least 90 mmHg.

Among the 129 patients with hypertension, 40% were continuous NSAID users and 60% were non-continuous or non-users.

After adjustment for potential confounders including disease activity and tumor necrosis factor (TNF) inhibitor use, the researchers found that continuous NSAID use was associated with a significant 12% increased risk for incident hypertension relative to non‐continuous or no use.

Furthermore, subgroup analyses showed that the association did not differ according to age, BMI, biologic use, or disease activity.

The findings were confirmed in sensitivity analyses, which also suggested an increased hypertension risk with TNF inhibitor use. However, the researchers note that these results were not significant across all models.

Nonetheless, Liew et al conclude that their study “highlights potential negative CV effects of first-line pharmacological therapy for AS.”

They add: “There is an unmet need to clarify how treatment choices, particularly the use of NSAIDs and TNF [inhibitors], impact CV risk factors and CV events in AS.”

By Laura Cowen

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

Arthritis Care Res 2019; doi:10.1002/acr.24070

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