Abstract | BACKGROUND:
Hypertension is more common in patients with rheumatoid arthritis (RA) than in the general population. It is unknown whether hypertension is due to RA-related medications or the disease itself. Therefore, we sought to investigate associations between RA-related autoantibodies, specifically antibodies to citrullinated protein antigens (ACPA) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) in first-degree relatives of RA patients, who were free of RA and RA-related medications. We hypothesized that a greater number of detectable ACPA would be associated with high SBP and DBP, independent of other risk factors in these first-degree relatives. METHODS: We evaluated associations between ACPA and SBP and DBP in a cross-sectional study of 72 first-degree relatives (defined as parent, child, or sibling) of RA patients. Fifteen ACPA were measured using a Bio-Plex bead-based assay; each was dichotomized as positive/negative based on pre-specified cut-points. Analysis of covariance was used to evaluate associations between ACPA positivity and SBP and DBP, adjusting for age, sex, race, body mass index (BMI), pack-years of smoking, high sensitivity C-reactive protein ( hsCRP), and current use of anti-hypertensive medications. RESULTS: Average age was 51 and 69% were women. Mean SBP was 119 ± 18 and DBP was 74 ± 9 mm Hg. Thirty-three (46%) first-degree relatives were positive for ≥1 ACPA; and were younger, had lower BMI, more pack-years of smoking, and higher hsCRP concentrations compared to ACPA negative first-degree relatives. For each additional positive ACPA, SBP was 0.98 ± 0.5 mm Hg (p = 0.05) higher, and DBP was 0.66 ± 0.3 mm Hg (p = 0.04) higher. Anti- cit- fibrinogen A (211-230) positive and anti- cit- filaggrin positive first-degree relatives had 11.5 and 13.9 mm Hg higher SBP (p = 0.02) respectively. Anti- cit- clusterin, cit- filaggrin, and cit- vimentin positive first-degree relatives had 7-8 mm Hg higher DBP (p = 0.03, 0.05, 0.05 respectively), compared to being negative for these individual ACPA. Consistent with associations between ACPA, SBP, and DBP, anti-cyclic citrullinated peptides (anti-CCP2) positive first-degree relatives had 16.4± (p = 0.03) higher SBP and 12.1± mm Hg (p = 0.01) higher DBP than anti-CCP2 negative first-degree relatives. CONCLUSION: In first-degree relatives without RA, ACPA positivity is associated with higher SBP and DBP. Subclinical autoimmune processes and ACPA may play a role in the vascular changes potentially leading to hypertension prior to RA onset.
|
Authors | Jan M Hughes-Austin, Ryan W Gan, Kevin D Deane, Michael H Weisman, M Kristen Demoruelle, Jeremy Sokolove, William H Robinson, V Michael Holers, Jill M Norris, Joachim H Ix |
Journal | American journal of nephrology
(Am J Nephrol)
Vol. 46
Issue 6
Pg. 481-487
( 2017)
ISSN: 1421-9670 [Electronic] Switzerland |
PMID | 29237149
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
|
Copyright | © 2017 S. Karger AG, Basel. |
Chemical References |
- Anti-Citrullinated Protein Antibodies
- FLG protein, human
- Filaggrin Proteins
|
Topics |
- Adult
- Aged
- Anti-Citrullinated Protein Antibodies
- Arthritis, Rheumatoid
(immunology)
- Blood Pressure
- Cross-Sectional Studies
- Family
- Female
- Filaggrin Proteins
- Humans
- Male
- Middle Aged
|