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Occurrence and predictive factors of high blood pressure, type 2 diabetes, and metabolic syndrome in rheumatoid arthritis: findings from a 3-year, multicentre, prospective, observational study


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22

 

  1. Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Italy. piero.ruscitti@univaq.it
  2. Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Italy.
  3. Department of Clinical and Experimental Medicine, Rheumatology Section, University of Campania Luigi Vanvitelli, Naples, Italy.
  4. Department of Clinical and Experimental Medicine, Rheumatology Section, University of Campania Luigi Vanvitelli, Naples, Italy.
  5. Department of Clinical and Experimental Medicine, Rheumatology Section, University of Campania Luigi Vanvitelli, Naples, Italy.
  6. Unit of Allergy, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Italy.
  7. Unit of Allergy, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Italy.
  8. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology section, University of Palermo, Italy.
  9. Department of Medical and Surgery Sciences, Rheumatology Unit, University of Foggia, Italy.
  10. Department of Experimental and Clinical Medicine, University of Florence, Italy.
  11. Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.
  12. Unità di Reumatologia, Ospedale L. Sacco, Milan, Italy.
  13. Rheumatology Research Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy.
  14. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, Italy.
  15. Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.
  16. Department of Biomedical Sciences and Human Oncology (DIMO), Rheumatologic and Systemic Autoimmune Diseases Unit, University of Bari Medical School, Italy.
  17. Department of Experimental and Clinical Medicine, University of Florence, Italy.
  18. Department of Medical and Surgery Sciences, Rheumatology Unit, University of Foggia, Italy.
  19. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology section, University of Palermo, Italy.
  20. Unit of Allergy, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Italy.
  21. Department of Clinical and Experimental Medicine, Rheumatology Section, University of Campania Luigi Vanvitelli, Naples, Italy.
  22. Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Italy.

CER13675
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PMID: 33337994 [PubMed]

Received: 08/06/2020
Accepted : 31/08/2020
In Press: 04/12/2020

Abstract

OBJECTIVES:
In rheumatoid arthritis (RA), “traditional” cardiovascular (CV) risk factors continue to be underdiagnosed and undertreated, thus increasing the risk of developing atherosclerosis. In this work, we evaluated the occurrence and predictive factors of “traditional” cardiovascular risk factors, with a focus on high blood pressure (HBP), type 2 diabetes (T2D), and metabolic syndrome (MetS), in participants with RA, in a 3-year, multicentre, prospective, observational study.
METHODS:
To assess the occurrence and predictive factors of HBP, T2D, and MetS, consecutive participants with RA, admitted to Italian Rheumatology Units, were evaluated in the GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale) cohort, a 3-year, multicentre, prospective, observational study.
RESULTS:
In the present evaluation, 841 participants, who were fully followed up with 3-year of prospective follow-up were assessed. At the end of follow-up, a significant increased incidence of HBP, T2D, and MetS was recorded. Assessing predictive factors, the mean values of C-reactive protein during the follow-up were independent predictors of occurrence of those comorbidities, whereas participants maintaining remission showed a significant lower risk. Furthermore, therapy with hydroxychloroquine (HCQ) reduced the risk of occurrence of T2D and MetS.
CONCLUSIONS:
An increased incidence of HBP, T2D, and MetS was observed in assessed participants, prospectively followed-up. Furthermore, the analysis of predictive factors suggested that the rheumatoid pro-inflammatory process could increase the occurrence of these comorbidities. Conversely, metabolic and cardiovascular benefits of maintaining remission as well as of therapy with HCQ were reported.

Rheumatology Article