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Systolic and pulse pressure associate with incident knee osteoarthritis: data from the Osteoarthritis Initiative

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Abstract

We evaluated the relationship of systolic blood pressure, diastolic blood pressure, pulse pressure, and treatment with antihypertensives with knee osteoarthritis incidence in a US cohort. We performed a longitudinal study (2004–2010) nested within the Osteoarthritis Initiative Study including only individuals without knee osteoarthritis at baseline. Systolic blood pressure, diastolic blood pressure, and pulse pressure were assessed at baseline, 12-, 24-, and 36-month visits. Knee radiographs at baseline, 12-, 24-, 36- and 48-month visits defined radiographic osteoarthritis, Kellgren and Lawrence grade ≥2. We performed logistic regression, adjusting for age, sex, body mass index, NSAID use, number of antihypertensive medications, diabetic medications, and cholesterol medications. One thousand nine hundred and thirty people (6040 observations) were included. Annual incidence rates of radiographic osteoarthritis by systolic blood pressure quartiles (lowest to highest) were 2.1, 3.4, 3.7, and 3.7%. Fully adjusted odds ratios of incident radiographic osteoarthritis (OA) for the 2nd-4th quartiles were 1.6, 1.7, and 1.6 relative to the lowest quartile (p for trend = 0.03). Pulse pressure results were similar. There was no association with diastolic blood pressure. Compared to those not taking any antihypertensive medications, those taking ≥3 had decreased odds (0.4, 0.1–1.0) of developing incident OA. In a US cohort, higher systolic blood pressure and pulse pressure are associated with increased incidence of radiographic knee osteoarthritis while treatment with ≥3 antihypertensive medications was associated with reduced incidence. These findings suggest a new and promising avenue for research on disease modification in knee osteoarthritis.

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Author information

Authors and Affiliations

  1. Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA

    Grace H. Lo & Nancy J. Petersen

  2. Medical Care Line and Research Care Line; VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA

    Grace H. Lo

  3. Division of Rheumatology, Tufts Medical Center, Boston, MA, USA

    Timothy E. McAlindon & Jeffrey B. Driban

  4. Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women’s Hospital, Boston, MA, USA

    Jeffrey N. Katz

  5. The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA

    Lori Lyn Price

  6. Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA

    Lori Lyn Price

  7. Department of Family Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI, USA

    Charles B. Eaton

  8. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA

    Charles B. Eaton

  9. Department of Medicine, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA

    Christie M. Ballantyne

  10. Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Maria E. Suarez-Almazor

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  1. Grace H. Lo
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  9. Maria E. Suarez-Almazor
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Contributions

Grace H. Lo had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Lo conducted and is responsible for the data analyses.

Study concept and design: Lo, McAlindon, Katz, Petersen, and Suarez-Almazor.

Acquisition of data: Lo.

Analysis and interpretation of data: Lo, McAlindon, Katz, Driban, Price, Eaton, Petersen, Ballantyne, and Suarez-Almazor.

Drafting of the manuscript: Lo.

Critical revision of the manuscript for important intellectual content: Lo, McAlindon, Katz, Driban, Price, Eaton, Petersen, Ballantyne, and Suarez-Almazor.

Statistical analysis: Lo, Petersen, and Suarez-Almazor.

Corresponding author

Correspondence to Grace H. Lo.

Ethics declarations

This study was approved by the Institutional Review Board at Baylor College of Medicine (K23 H-30423). Each participant provided written informed consent.

Disclosure

None.

Funding statement

This work was supported by the National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases [K23 AR062127 to G.L., K24 AR053593 to M.S.]; the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety [CIN 13-413], Michael E. DeBakey VA Medical Center, Houston Texas, the location of Dr. Lo’s academic office; and the Osteoarthritis Initiative, a public-private partnership composed of five contracts [N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262] funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and 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. These contracts supported collection and management of data collected in this study. This manuscript has received the approval of the OAI Publications Committee based on a review of its scientific content and data interpretation. The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs, the National Institutes of Health, or the US government.

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Lo, G.H., McAlindon, T.E., Katz, J.N. et al. Systolic and pulse pressure associate with incident knee osteoarthritis: data from the Osteoarthritis Initiative. Clin Rheumatol 36, 2121–2128 (2017). https://doi.org/10.1007/s10067-017-3656-z

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