The influence of mean blood pressure on arterial stiffening and endothelial dysfunction in women with rheumatoid arthritis and systemic lupus erythematosus

Alma Čypienė,Milda Kovaitė,Aleksandras Laucevičius,Ligita Ryliškytė,Algirdas Venalis,Rita Rugienė,Jolanta Dadonienė,Žaneta Petrulionienė

doi:10.3390/medicina46080075

Alma Čypienė, Milda Kovaitė + Show 6 more

Open Access

https://doi.org/10.3390/medicina46080075

Copy DOI

Abstract

To investigate the carotid-radial pulse wave velocity, augmentation index, and flow-mediated dilation of the brachial artery and factors possibly influencing them in women with rheumatoid arthritis and systemic lupus erythematosus. A total of 63 women with rheumatoid arthritis, 31 with systemic lupus erythematosus, and 72 controls, aged 18-55 years, were examined. Parameters of arterial stiffness, augmentation index and carotid-radial pulse wave velocity, were obtained by applanation tonometry (Sphygmocor (v.7.01) AtCor Medical). Flow-mediated dilatation of the brachial artery, reflecting endothelial function was determined by ultrasound system (Logiq 7, General Electric). The groups of women with rheumatoid arthritis and systemic lupus erythematosus lupus differed from controls regarding augmentation index (P<0.001; P=0.008) and did not differ between each other. Women with systemic lupus erythematosus differed from controls regarding pulse wave velocity (P=0.018), while women with rheumatoid arthritis - did not. Flow-mediated dilatation in both the groups of diseases was not different from controls. In rheumatoid arthritis patients, mean blood pressure was the main explanatory factor for augmentation index and pulse wave velocity; vessel diameter and high-density lipoprotein cholesterol - for flow-mediated dilatation. In women with systemic lupus erythematosus, pulse wave velocity was not related to any of the pending parameters; augmentation index was dependent on organ damage index, age, and mean blood pressure, and flow-mediated dilatation on vessel diameter, body mass index, and disease duration. The mean blood pressure was the major and the only one risk factor of arterial stiffening in rheumatoid arthritis, while the disease damage index played the most important role in the systemic lupus erythematosus group. The mean blood pressure in the systemic lupus erythematosus group was not as important as in the rheumatoid arthritis group, though may have a partial influence.

Highlights

The increased prevalence of premature atherosclerosis in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) is well established
Both of them differed from the control group with respect to augmentation index (AIx) (PSLE vs controls=0.008; PRA vs controls
This study showed that aortic AIx, the marker of early atherosclerosis, the parameter systemic arterial stiffness, is modified in RA and SLE patients, and a significant difference was detected in both diseases as compared with controls

Summary

Introduction

The increased prevalence of premature atherosclerosis in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) is well established. Patients with RA are at the increased risk of development premature cardiovascular disease that shortens life by 3 to 18 years [1]. The influence of mean blood pressure on arterial stiffening and endothelial dysfunction increased arterial stiffness, the important assessment in the diagnosis of early atherosclerosis, recently have been described widely in patients with RA and SLE [3,4,5,6,7,8,9,10,11]. The aim of this study was to determine the carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) as a derivate marker of arterial wall dysfunction and endothelium-dependent flow-mediated dilatation (FMD) and factors possibly influencing them in middle-aged RA and SLE women without significant organ damage and to compare them to healthy controls

Objectives

Methods

Results

Discussion

Conclusion