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Endothelial Dysfunction in Patients with Rheumatoid Arthritis: the Role of Hypertension

  • Inflammation and Cardiovascular Diseases (A Kirabo, Section Editor)
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Abstract

Purpose of Review

To review the data on the role of endothelial dysfunction and the impact of hypertension as a potent mediator of cardiovascular disease in patients with rheumatoid arthritis (RA).

Recent Findings

RA represents the most common autoimmune rheumatic disorder and is characterized by chronic systemic inflammation predisposing to cardiovascular complications. Cardiovascular mortality is increased among patients with RA and represents the leading cause of death. Although the exact prevalence is debated, hypertension is increased in RA. Hypertension acts synergistically with chronic inflammation and accounts, at least partially, for the increased cardiovascular morbidity in this group of patients. Endothelial dysfunction is considered a primary process in the pathogenesis of hypertension and cardiovascular diseases and contributes significantly to the development and progression of the associated micro- and macrovascular complications. Even though several studies in patients with RA have shown the presence of endothelial dysfunction with traditional methods, novel biochemical and vascular methods for the evaluation of endothelial dysfunction have been scarcely applied. In addition, it remains unclear whether and to which extent endothelial dysfunction in RA is present regardless of concomitant hypertension, even in well-controlled patients.

Summary

Hypertension, endothelial dysfunction, and chronic systemic inflammation appear as a mutually reinforcing triad aggravating cardiovascular risk in patients with RA. Detection of endothelial dysfunction in patients with RA in the early stages further aiming at the development of novel therapeutic targets might contribute to prevention of cardiovascular complications and remains under investigation.

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Acknowledgements

The authors would like to thank Dr. Barbara Nikolaidou for her assistance in the preparation of the figure and table.

Funding

This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme “Human Resources Development, Education and Lifelong Learning 2014-2020” in the context of the project “Evaluation of novel markers of endothelial dysfunction and thrombotic microenvironment in patients with rheumatoid arthritis: association with markers of subclinical inflammation and cardiovascular damage (MIS 5047870).”

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  1. 3rd Department of Internal Medicine, Papageorgiou Hospital, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece

    P. Anyfanti, E. Gavriilaki, S. Douma & E. Gkaliagkousi

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  1. P. Anyfanti
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Anyfanti, P., Gavriilaki, E., Douma, S. et al. Endothelial Dysfunction in Patients with Rheumatoid Arthritis: the Role of Hypertension. Curr Hypertens Rep 22, 56 (2020). https://doi.org/10.1007/s11906-020-01064-y

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