Arterial hypertension in spondyloarthritis patients was associated with significantly increased vascular stiffness, thicker carotid intima-media, and higher ESR compared to normotensive patients.
Cross-Sectional (n=123)
Does arterial hypertension worsen ultrasound indices of arterial stiffness and subclinical atherosclerosis in patients with spondyloarthritis?
Arterial hypertension in spondyloarthritis is associated with significantly increased vascular stiffness and systemic inflammation, highlighting the need for strict blood pressure control to mitigate cardiovascular risk.
Objective: Arterial stiffness is a hallmark of subclinical atherosclerosis and an early indicator of cardiovascular (CV) risk in spondyloarthritis (SpA). Both chronic inflammation and arterial hypertension (HT) promote vascular remodeling; however, their combined effect on arterial properties in SpA has not been fully elucidated. To assess the impact of arterial hypertension on ultrasound indices of arterial stiffness and subclinical atherosclerosis in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA), and to explore its association with inflammatory parameters.Design and method: Participants with AS and PsA were stratified according to the presence of HT. Vascular stiffness was evaluated by ultrasound methods: carotid intima–media thickness (CIMT), echo-tracking of carotid arteries, consisting of beta-stiffness index, augmentation index (AI), pulse wave velocity (PWV), arterial compliance (AC), and elastic modulus (Ep). Inflammatory markers (erythrocyte sedimentation rate - ESR, C-reactive protein, CRP), were analyzed. Comparisons between hypertensive and normotensive groups were performed using the Mann–Whitney U test. Results: A total of 123 SpA patients were included in the study (83 AS and 40 PsA), mean age 49,3 years. The number of hypertensive patients was 81 and the result of ultrasound examination demonstrated significantly higher values of CIMT, beta-stiffness, AI, PWV and Ep, reflecting increased arterial rigidity and vascular remodeling. ESR was also significantly higher among hypertensive subjects, while CRP did not differ between groups (tabl. 1). In terms of number of smokers and the values of lipid parameters, the groups of hypertensive and non-hypertensive patients were comparable. Table 1. Comparison of inflammatory and vascular parameters between hypertensive and normotensive SpA patients. Conclusions: Arterial hypertension in SpA is associated with significantly increased vascular stiffness, thicker carotid intima–media, and higher ESR, indicating a synergistic interaction between systemic inflammation and elevated blood pressure. These combined factors accelerate vascular aging and subclinical atherosclerosis, emphasizing the importance of early integration of cardiovascular risk evaluation with carotid ultrasound examination and strict blood pressure control in SpA management plan.
Dimova et al. (Fri,) conducted a cross-sectional in Spondyloarthritis (Ankylosing Spondylitis and Psoriatic Arthritis) (n=123). Arterial hypertension vs. Normotension was evaluated on Ultrasound indices of arterial stiffness (CIMT, beta-stiffness index, AI, PWV, AC, Ep) and inflammatory markers. Arterial hypertension in spondyloarthritis patients was associated with significantly increased vascular stiffness, thicker carotid intima-media, and higher ESR compared to normotensive patients.