Chronic systemic inflammation as a risk factor for hypertension in patients with ankylosing spondylitis

Aim. To study cardiovascular risk factors in patients with ankylosing spondylitis and to evaluate the role of active systemic inflammation in the development of hypertension in this group of patients.

Methods. The study included 202 patients divided into 4 groups (Group 1: 28 people with hypertension who were not diagnosed with ankylosing spondylitis, Group 2: 60 patients with ankylosing spondylitis without hypertension, Group 3: 45 patients with ankylosing spondylitis and hypertension, Control Group 4: 69 people). The studies performed included physical examination with assessment of BASDAI, ASDAS-CRP, BASFI, MASES indices, biochemical blood analysis with determination of C-reactive protein, daily monitoring of blood pressure.

Results. The ASDAS-CRP index (p = 0.04) and the duration of spondylitis (p = 0.021) are higher in the group of patients with ankylosing spondylitis and arterial hypertension than in the group of patients with eutonic spondylitis. In the group of patients with spondylitis and arterial hypertension, a very high degree of disease activity is common, 42.2% versus 16.7% in the group of eutonic patients with ankylosing spondylitis (p = 0.006). The resting heart rate was found to be higher in patients with ankylosing spondylitis with hypertension, in contrast to the control group (p = 0.001) and the group of patients with spondylitis without hypertension (p = 0.009). Besides, cholesterol levels are higher in the group of patients with ankylosing spondylitis with hypertension compared with the control group (p = 0.015). It should be noted that in the group of patients with ankylosing spondylitis and arterial hypertension and in the group of eutonic patients with spondylitis, there were no statistical differences in the intake of nonsteroidal anti-inflammatory drugs.

Conclusion. Thus, our study confirms that one of the pathogenic factors in the development of arterial hypertension in patients with ankylosing spondylitis is a long-term systemic inflammatory process. In this regard, the level of C-reactive can be considered as an additional predictor of the development of hypertension in this group of patients.

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