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Association of blood pressure with knee cartilage composition and structural knee abnormalities: data from the osteoarthritis initiative

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Abstract

Objective

To investigate the associations of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with changes in knee cartilage composition and joint structure over 48 months, using magnetic resonance imaging (MRI) data from the Osteoarthritis Initiative (OAI).

Materials and methods

A total of 1126 participants with right knee Kellgren-Lawrence (KL) score 0–2 at baseline, no history of rheumatoid arthritis, blood pressure measurements at baseline, and cartilage T2 measurements at baseline and 48 months were selected from the OAI. Cartilage composition was assessed using MRI T2 measurements, including laminar and gray-level co-occurrence matrix texture analyses. Structural knee abnormalities were graded using the whole-organ magnetic resonance imaging score (WORMS). We performed linear regression, adjusting for age, sex, body mass index, physical activity, smoking status, alcohol use, KL score, number of anti-hypertensive medications, and number of nonsteroidal anti-inflammatory drugs.

Results

Higher baseline DBP was associated with greater increases in global T2 (coefficient 0.22 (95% CI 0.09, 0.34), P = 0.004), global superficial layer T2 (coefficient 0.39 (95% CI 0.20, 0.58), P = 0.001), global contrast (coefficient 15.67 (95% CI 8.81, 22.53), P < 0.001), global entropy (coefficient 0.02 (95% CI 0.01, 0.03) P = 0.011), and global variance (coefficient 9.14 (95% CI 5.18, 13.09), P < 0.001). Compared with DBP, the associations of SBP with change in cartilage T2 parameters and WORMS subscores showed estimates of smaller magnitude.

Conclusion

Higher baseline DBP was associated with higher and more heterogenous cartilage T2 values over 48 months, indicating increased cartilage matrix degenerative changes.

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Acknowledgments

We would like to thank the participants and staff of the Coordinating Center of the OAI for their invaluable assistance with patient selection, statistical analysis, and technical support.

Funding

This project was supported by the Osteoarthritis Initiative (OAI), a public-private partnership comprised of five contracts (National Institute of Arthritis and Musculoskeletal and Skin Diseases contracts N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262) funded by the National Institutes of Health (NIH), with research conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This study was also supported by NIH/NIAMS grants (R01AR064771, P50-AR060752) and the National Center for Advancing Translational Sciences, NIH, through UCSF-CTSI Grant Number TL1 TR001871.

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Authors and Affiliations

  1. Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA

    Walid Ashmeik, Gabby B. Joseph & Thomas M. Link

  2. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    Michael C. Nevitt & Charles E. McCulloch

  3. Department of Medicine and Center for Musculoskeletal Health, University of California, Davis, Sacramento, CA, USA

    Nancy E. Lane

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  1. Walid Ashmeik
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  2. Gabby B. Joseph
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Correspondence to Walid Ashmeik.

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The authors declare that they have no conflict of interest.

Ethical approval

Informed consent was obtained from all individual participants included in the study. The OAI study was compliant with the Health Insurance Portability and Accountability Act and was approved by the local institutional review board of each OAI participating center. All procedures performed in this study were in accordance with the ethical standards of the local institutional review board and with the 1964 Helsinki declaration and its later amendments.

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Ashmeik, W., Joseph, G.B., Nevitt, M.C. et al. Association of blood pressure with knee cartilage composition and structural knee abnormalities: data from the osteoarthritis initiative. Skeletal Radiol 49, 1359–1368 (2020). https://doi.org/10.1007/s00256-020-03409-9

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