POS0130 ASSOCIATION BETWEEN HYPERTENSION AND OSTEOARTHRITIS

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Background:Objectives:To evaluate the relationship between arterial hypertension (AH) and the course of knee osteoarthritis (OA).Methods:The prospective study included 109 women aged 38-75 y.o., of I-III Kellgren J. - Lawrence J. stage of knee OA (ACR), who signed an informed consent. The average age was 59.3 ± 8.7 y.o. (from 38 to 74), the average duration of the OA was 7 (4-12) years. The average values of the body mass index (BMI) corresponded to obesity (30.9 ± 5.4 kg / m2), waist circumference (WC) – 94.4 ± 11.7 cm. An individual card was filled in for each patient, including anthropometric parameters, anamnesis and clinical examination data, assessment of knee joint pain according to VAS, WOMAC, KOOS and DN4 indices, and concomitant diseases. All patients underwent standard X-ray of the knee joints, laboratory examination.Results:AH was diagnosed in 69.7 % patients with OA. Patients were divided into 2 groups, according to the presence or absence of AH (Table 1). Patients with AH were older, had a higher BMI, WC, a longer duration of menopause and significantly earlier its onset (p<0.05). Patients with OA and AH had a more severe course of OA: higher values of pain in VAS, total WOMAC and all its components, DN4, worse indicators of total KOOS (p<0.05). X-ray examination showed a tendency to a more significant narrowing of the medial space of the knee joints (p = 0.07). Laboratory examination showed higher values of CRP, ESR, IL-6, and leptin (p < 0.05).Table 1.Comparative characteristics of OA patients with and without AHParametersPatients with AH(n=76)Patients without AH(n=33)pAge, y.o.61 (57-68)55.5 (49-58)<0.01WC, cm92 (90-105)86.5 (84-90)<0.01Age of menopause, y.o.50 (47-52)55.5 (49-58)0.02Duration of menopause, years14 (7.5-19)7 (4-8)<0.01Duration of OA, years10 (5-15)4 (1-6)0.001VAS pain score, mm49 (40-57)42 (24-50)0.02WOMAC pain, mm189.5 (140-250)140 (108-162)0.001WOMAC stiffness, mm77.5 (42-100)56 (33.5-71.5)0.01WOMAC functional impairment (FI), mm651 (547-902)546.5 (320-663.5)0.002Total WOMAC, mm899 (728-1280)734 (526.5-882)0.001KOOS, points0.47 (0.36-0.57)0.6 (0.53-0.75)<0.01DN4, points2 (1-3)1 (0-2)0.01Overall health status, mm45 (35-55)36.5 (28.5-48.5)0.02The size of the medial space of joint according to X-ray, mm2.45 (1.35-4.35)3.6 (2.8-4.3)0.07CRP, mg/l2.38 (1.47-4.85)1.21 (0.69-2.53)<0.01Leptin, ng/ml37.4 (26.5-53.3)23.6 (15.1-40.2)0.01IL-6, pg/ml0.7 (0.4-1.2)0.45 (0.3-0.7)0.03ESR, mm/h14 (7-18)7 (6-12)0.02We founded positive (р <0.05) associations between AH and a more severe, prolonged course of OA (r=-0.39, p<0.01) in the the Spearman rank-order correlation coefficient analysis. Thus, patients with AH had higher values of VAS pain (r=0.31, p<0.01), total WOMAC (r=0.31, p<0.01) and all its components (pain (r=0.33, p<0.01), FI (r=0.3, p<0.01) and stiffness (r=0.24, p<0.01), DN4 (r=0.24, p=0.01), worse indicators of total KOOS (r=-0.42, p<0.01) and overall health status (r=0.23, p=0.02), more often detected more advanced stage of OA (r=0.24, p=0.03) and synovitis (r=0.23, p=0.01). In addition, positive relationships were found with CRP (r=0.31, p<0.01), IL - 6 (r=0.3, p=0.03), ESR (r=0.3, p=0.02). Positive relationships were confirmed between AH and age (r=0.39, p<0.01), menopause duration (r=0.39, p<0.01), WC (r=0.37, p<0.01), leptin (r=0.35, p=0.01), the presence of hypertriglyceridemia (r=0.35, p=0.01) and cardiovascular risks according to SCORE (r=0.26, p=0.02), considering traditional risk factors for cardiovascular diseases (CVD).Conclusion:Thus, we found that AH in patients with knee OA is affected by a variety of variables, both related to traditional CVD factors and to OA itself, and the correlations found are approximately equal in strength. The results obtained require further study, and it is possible that preventive measures aimed at reducing the traditional risk factors of diseases of the circulatory system, or correcting existing CVD, will contribute to a more favorable course of OA.Disclosure of Interests:None declared