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P4444Hypertension, autoimmune inflammation and salt sensitivity in women with rheumatoid arthritis

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Hypertension (HTN) takes the first place among cardiovascular diseases in patients with rheumatoid arthritis (RA). Currently, the main risk factors for hypertension are known, but eating habits are often not… Click to show full abstract

Hypertension (HTN) takes the first place among cardiovascular diseases in patients with rheumatoid arthritis (RA). Currently, the main risk factors for hypertension are known, but eating habits are often not considered in patients with RA. The salt taste sensitivity threshold (STST) in women with autoimmune inflammation and the effect of salt sensitivity to hypertension in RA have not been practically studied which was the novelty of our study. Purpose is to determine the salt taste sensitivity threshold in women with RA and assess the correlation between salt sensitivity, autoimmune inflammation and the development of hypertension in women with RA. STST was studied in all patients with RA (n=202). Then, to assess the risk factors for hypertension in RA, the patients were divided into 2 groups: group 1 – patients with hypertension (n=141), group 2 – patients without hypertension (n=61). The patients' examination was carried out using the standards of the Association of Rheumatologists of Russia and the Russian Society of Cardiology. Salt taste sensitivity threshold was determined with R.J. Henkin's method. The patients with middle and high STST were considered salt-sensitive. Statistical data were obtained with Statistica 10.0. Regression analysis was used to identify the correlation between risk factors and the development of hypertension. The following results based on STST testing were obtained in patients with RA (n=202): high STST was in 129 patients (64.3%), middle - in 20 patients (10.7%), low - in 53 patients (25.0%). The activity of the inflammatory process was significantly higher in salt-sensitive patients (p=0.01). According to regression analysis, the predictors for hypertension in women with RA, in order of importance were age >55 years (p=0.001), early menopause (p=0.001), increased total cholesterol (p=0.001), taking prednisolone >10 mg/day (p=0.001), early family history of cardiovascular diseases (p=0.01), reduced glomerular filtration rate <60 ml/min 1.73 m2 (p=0.01), high STST (p=0.01), pregnancy pathology (p=0.01), high activity of the inflammatory process (p=0.01), psychosocial factors (stress, anxiety, depression) (p=0.01), obesity (p=0.01), RA duration >10 years (p=0.01). There were twice as many salt-sensitive patients with RA and HTN as with RA and without HTN (87% and 48%, respectively). Excessive fluid in the body was observed with decreased natriuresis that assumes the presence of volume-dependent hypertension. The results of the study showed the importance to determine STST associated with a set of factors and autoimmune inflammation was significant among them. The widespread application of the method determining the salt sensitivity will make it possible to increase the effectiveness of hypertension treatment based on individual recommendations for women with RA.

Keywords: sensitivity; autoimmune inflammation; hypertension; salt sensitivity

Journal Title: European Heart Journal
Year Published: 2019

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