Leeds, UK—Pharmacists counsel many patients who regularly use oral steroids to help control symptoms from chronic inflammatory diseases.
Now, a new study published in the Canadian Medical Association Journal warns that cumulative doses of oral steroids in those patients are associated with increased hypertension rates.
“The cumulative effect of oral steroid doses on hypertension is substantial, and given that these are commonly prescribed medications, the related health burden could be high,” explained lead researcher Mar Pujades-Rodriguez, PhD, of the Leeds Institute of Health Sciences in the United Kingdom.
The report notes that few population-based studies have examined the association between glucocorticoids and hypertension and that results have been inconsistent.
To remedy that, the study team analyzed electronic health records from 389 practices in England during 1998 to 2017; the focus was on adults diagnosed with any of six chronic inflammatory diseases but with no previous diagnosis of hypertension. The most common underlying diseases were inflammatory bowel disease (35%) and rheumatoid arthritis (28%).
Glucocorticoid-prescription data was used estimate incidence rates and adjusted hazard ratios (HRs) for hypertension. Researchers determined that, among 71,642 patients in the cohort, 24,896 (34.8%) developed hypertension during a median follow-up of 6.6 years.
Results indicate that the incidence rate of hypertension was 46.7 (95% confidence interval [CI] 46.0-47.3) per 1,000 person-years. Incidence rates increased with higher cumulative glucocorticoid prednisolone-equivalent dose, from 44.4 per 1,000 person-years in periods of nonuse to 45.3 per 1,000 person-years for periods with between >0.0 and 959.9 mg (HR 1.14; 95% CI, 1.09-1.19), to 49.3 per 1,000 person-years for periods with 960 to 3054.9 mg (HR 1.20; 95% CI, 1.14-1.27), and to 55.6 per 1,000 person-years for periods with ≥3,055 mg (HR 1.30; 95% CI, 1.25-1.35). Researchers add that cumulative effects were seen for the six diseases studied, but dose-response effects were not found for daily dose.
“Cumulative dose of oral glucocorticoids was associated with increased incidence of hypertension, suggesting that blood pressure should be monitored closely in patients routinely treated with these drugs,” the authors conclude. “Given that glucocorticoids are widely prescribed, the associated health burden could be high.”
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Now, a new study published in the Canadian Medical Association Journal warns that cumulative doses of oral steroids in those patients are associated with increased hypertension rates.
“The cumulative effect of oral steroid doses on hypertension is substantial, and given that these are commonly prescribed medications, the related health burden could be high,” explained lead researcher Mar Pujades-Rodriguez, PhD, of the Leeds Institute of Health Sciences in the United Kingdom.
The report notes that few population-based studies have examined the association between glucocorticoids and hypertension and that results have been inconsistent.
To remedy that, the study team analyzed electronic health records from 389 practices in England during 1998 to 2017; the focus was on adults diagnosed with any of six chronic inflammatory diseases but with no previous diagnosis of hypertension. The most common underlying diseases were inflammatory bowel disease (35%) and rheumatoid arthritis (28%).
Glucocorticoid-prescription data was used estimate incidence rates and adjusted hazard ratios (HRs) for hypertension. Researchers determined that, among 71,642 patients in the cohort, 24,896 (34.8%) developed hypertension during a median follow-up of 6.6 years.
Results indicate that the incidence rate of hypertension was 46.7 (95% confidence interval [CI] 46.0-47.3) per 1,000 person-years. Incidence rates increased with higher cumulative glucocorticoid prednisolone-equivalent dose, from 44.4 per 1,000 person-years in periods of nonuse to 45.3 per 1,000 person-years for periods with between >0.0 and 959.9 mg (HR 1.14; 95% CI, 1.09-1.19), to 49.3 per 1,000 person-years for periods with 960 to 3054.9 mg (HR 1.20; 95% CI, 1.14-1.27), and to 55.6 per 1,000 person-years for periods with ≥3,055 mg (HR 1.30; 95% CI, 1.25-1.35). Researchers add that cumulative effects were seen for the six diseases studied, but dose-response effects were not found for daily dose.
“Cumulative dose of oral glucocorticoids was associated with increased incidence of hypertension, suggesting that blood pressure should be monitored closely in patients routinely treated with these drugs,” the authors conclude. “Given that glucocorticoids are widely prescribed, the associated health burden could be high.”
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