Glucocorticoid users risk developing hypertension

Use of glucocorticoid (GC) at doses ≥7.5 mg poses an increased risk of incident hypertension among patients with rheumatoid arthritis (RA), a study has found.

Researchers looked at a cohort of 17,760 RA patients (mean age, 56.3 years; 68 percent female), among whom 7,421 (41.8 percent) were prescribed GCs during follow-up. GC users were slightly older (mean age, 57.7 vs 55.3 years), were predominantly female, had a history of smoking, and had more comorbidities compared with nonusers.

A total of 6,243 cases of hypertension (defined as blood pressure [BP] levels >140/90 mm Hg or BP-lowering medication prescriptions) occurred over 97,547 person-years of follow-up, with an incidence rate of 64.1 per 1,000 person-years. The incidence rate was higher among GC users than nonusers (87.6 vs 59.7 per 1,000 person-years).

Multivariable Cox proportional hazards analysis showed that GC use was associated with a 17-percent increased risk of hypertension (hazard ratio [HR], 1.17, 95 percent confidence interval [CI], 1.10–1.24).

When analysed by dose, a significant risk increase was noted only for GC use at doses ≥7.5 mg (7.5–14.9 mg: HR, 1.18, 95 percent CI, 1.08–1.29; ≥15 mg: HR, 1.36, 95 percent CI, 1.18–1.56). There was no clear pattern observed for cumulative dose.

The findings underscore the need for clinicians to consider cardiovascular risk when prescribing GCs, ensuring BP is regularly monitored and treated where necessary, according to the researchers.