AB0218 ASSOCIATION OF PULSE PRESSURE AND CAROTID INTIMA MEDIA THICKNESS IN RHEUMATOID ARTHRITIS PATIENTS

Abstract

BackgroundRheumatoid arthritis (RA) patients have increased cardiovascular risk than the general population. Systemic inflammation causes a proatherogenic state in this group of patients (1). The carotid ultrasound is a useful diagnostic tool for the detection of subclinical atherosclerosis; however, it is not available for all patients. Pulse pressure, defined as the difference between systolic and diastolic blood pressure, has been associated with atherosclerosis in the general population (2). Information in RA patients is lacking.ObjectivesWe aimed to correlate pulse pressure and carotid intima media thickness (cIMT) in RA patients.MethodsThis was a cross-sectional study. We recruited a total of 92 patients with RA diagnosis, according to the 2010 EULAR/ACR classification criteria, aged 40-75 years. Patients with a previous cardiovascular event, another connective tissue disease or pregnancy were excluded. A B-mode carotid ultrasound was performed in all patients by a certified radiologist blinded to clinical information. cIMT was measured in the left and right carotid arteries. An average of both cIMT was obtained for each patient for this analysis. Correlation between pulse pressure and cIMT was determined with the Spearman’s correlation coefficient (rs). A p-value <0.05 was considered statistically significant.ResultsMean age of RA patients was 58.9 ± 6.6 years. Most of them were women (92.4%), with a median disease duration of 10.5 (4.2-17.5) years. Median cIMT was 0.08 (0.07-0.10) mm, and median pulse pressure was 50 (40-55) mmHg (Table 1). We found a significant positive correlation between pulse pressure and cIMT in RA patients (rs = 0.254, p = 0.015) (Figure 1).Table 1.Demographic and disease characteristics.CharacteristicsRA patients (n=92)Age, years, mean ± SD58.9 ± 6.6Women, n (%)85 (92.4)T2DM, n (%)17 (18.5)Hypertension, n (%)33 (35.9)Dyslipidemia, n (%)30 (32.6)Obesity, n (%)30 (32.6)Active smoking, n (%)11 (12.0)Disease duration, years, median (IQR)10.5 (4.2-17.5)CRP, mg/dL, median (IQR)0.70 (0.51-1.22)ESR, mm/h, median (IQR)21.0 (13.0-33.2)Pulse pressure, mmHg, median (IQR)50 (40-55)cIMT, mm, median (IQR)0.08 (0.07-0.10)RA, rheumatoid arthritis; T2DM, type 2 diabetes mellitus; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; cIMT, carotid intima media thickness.ConclusionHigher pulse pressure was associated with higher cIMT in RA patients. Pulse pressure may be useful for the detection of high-risk patients who would benefit from a carotid ultrasound evaluation, to identify patients with high cIMT.References[1]Dalbeni A, Giollo A, Bevilacqua M, et al. Traditional cardiovascular risk factors and residual disease activity are associated with atherosclerosis progression in rheumatoid arthritis patients. Hypertens Res 2020;43(9):922–8.[2]Zureik M, Touboul PJ, Bonithon-Kopp C, et al. Cross-sectional and 4-year longitudinal associations between brachial pulse pressure and common carotid intima-media thickness in a general population. The EVA study. Stroke 1999;30(3):550-5.Disclosure of InterestsNone declared