Cardiovascular organ damage in relation to hypertension status in patients with ankylosing spondylitis

• Published in: Blood pressure 2023-12, Vol.32 (1), p.2205956-2205956
• Main Authors: Ullensvang, Gyda, Kringeland, Ester, Ikdahl, Eirik, Provan, Sella, Berg, Inger Jorid, Rollefstad, Silvia, Dagfinrud, Hanne, Gerdts, Eva, Semb, Anne Grete, Midtbø, Helga
• Format: Article
• Language: English
• Subjects: Adult; Ankylosing spondylitis; arterial stiffness; Blood Pressure; cardiovascular organ damage; Carotid Arteries; carotid ultrasound; echocardiography; Female; Humans; Hypertension; Male; Middle Aged; Pulse Wave Analysis; Risk Factors; Spondylitis, Ankylosing - complications
• ISSN: 0803-7051; 1651-1999
• DOI: 10.1080/08037051.2023.2205956

What is the context? Ankylosing spondylitis (AS) is an inflammatory disease primarily affecting the spine. Patients with AS have increased risk for cardiovascular disease. High blood pressure (hypertension) is both very common in AS patients, and a major risk factor for developing cardiovascular disease. Hypertension leads to structural and functional changes in the heart and arteries, referred to as cardiovascular organ damage. However, little is known about the prevalence of cardiovascular organ damage in AS patients with hypertension. What is new? Using ultrasound and tonometry, we assessed organ damage in the heart and arteries in AS patients with hypertension and compared them to AS patients with normal blood pressure as well as a group of healthy controls. We found that 84% of the AS patients with hypertension had cardiovascular organ damage, compared to 29% of AS patients with normal blood pressure and 30% of controls. Independent of other risk factors, hypertension was associated with a fourfold increased risk of cardiovascular organ damage in AS patients. What is the impact? These findings are important because cardiovascular organ damage is potentially reversible with treatment. Our results underline the significance of guideline-directed hypertension management in AS patients to reduce cardiovascular disease. Hypertension is a major cardiovascular (CV) risk factor in ankylosing spondylitis (AS) patients. Less is known about the prevalence of CV organ damage in relation to hypertension status in AS patients. CV organ damage was assessed by echocardiography, carotid ultrasound and pulse wave velocity (PWV) by applanation tonometry in 126 AS patients (mean age 49 ± 12 years, 39% women) and 71 normotensive controls (mean age 47 ± 11 years, 52% women). CV organ damage was defined as presence of abnormal left ventricular (LV) geometry, LV diastolic dysfunction, left atrial (LA) dilatation, carotid plaque or high pulse wave velocity (PWV). Thirty-four percent of AS patients had hypertension. AS patients with hypertension were older and had higher C-reactive protein (CRP) levels compared to AS patients without hypertension and controls (p