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Mangoni AA, Baghdadi LR, Shanahan EM, et al. Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study. Ther Adv Musculoskelet Dis. 2017;9(9):213-229doi: 10.1177/1759720X17719850.
Mangoni, A. A., Baghdadi, L. R., Shanahan, E. M., Wiese, M. D., Tommasi, S., Elliot, D., & Woodman, R. J. (2017). Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study. Therapeutic advances in musculoskeletal disease, 9(9), 213-229. https://doi.org/10.1177/1759720X17719850
Mangoni, Arduino A, et al. "Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study." Therapeutic advances in musculoskeletal disease vol. 9,9 (2017): 213-229. doi: https://doi.org/10.1177/1759720X17719850
Mangoni AA, Baghdadi LR, Shanahan EM, Wiese MD, Tommasi S, Elliot D, Woodman RJ. Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study. Ther Adv Musculoskelet Dis. 2017 Sep;9(9):213-229. doi: 10.1177/1759720X17719850. Epub 2017 Aug 01. PMID: 28932292; PMCID: PMC5600310.
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Ther Adv Musculoskelet Dis. 2017 Sep;9(9):213-229. doi: 10.1177/1759720X17719850. Epub 2017 Aug 01.

Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study.

Therapeutic advances in musculoskeletal disease

Arduino A Mangoni, Leena R Baghdadi, E Michael Shanahan, Michael D Wiese, Sara Tommasi, David Elliot, Richard J Woodman

Affiliations

  1. Department of Clinical Pharmacology, School of Medicine, Flinders University and Flinders Medical Centre, Bedford Park, SA 5042, Australia.
  2. Department of Clinical Pharmacology, School of Medicine, Flinders University and Flinders Medical Centre, Adelaide, Australia.
  3. Department of Rheumatology, Flinders University and Southern Adelaide Local Health Network, Adelaide, Australia.
  4. School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
  5. Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Adelaide, Australia.

PMID: 28932292 PMCID: PMC5600310 DOI: 10.1177/1759720X17719850

Abstract

BACKGROUND: Methotrexate (MTX) treatment in rheumatoid arthritis (RA) has been associated with lower cardiovascular risk compared to other disease-modifying antirheumatic drugs (DMARDs). We sought to identify whether the MTX-associated cardioprotection involves changes in blood pressure (BP) and/or arterial function.

METHODS: Clinic and 24-hour peripheral and central systolic and diastolic BP (SBP and DBP), augmentation index (AIx), pulse wave velocity (PWV) and plasma asymmetric dimethylarginine (ADMA) were assessed in RA patients on stable treatment with either MTX ± other DMARDs (MTX group,

RESULTS: After adjusting for visit, age, gender, body mass index, folic acid use and 28-joint disease activity score, the MTX group had significantly lower clinic peripheral SBP (-7.7 mmHg, 95% CI -13.2 to -2.3,

CONCLUSIONS: RA patients on MTX treatment had significantly lower clinic and 24-hour peripheral and central BP compared to those who did not take MTX. The lower BP with MTX may be related to differences in PWV, but not in AIx or ADMA concentrations. Further longitudinal studies including randomized controlled trials are warranted to confirm these findings, to identify other possible mechanisms responsible for the effects of MTX on BP and PWV, and to establish whether these effects might account for the reduced cardiovascular risk with MTX.

Keywords: asymmetric dimethylarginine; augmentation index; blood pressure; disease-modifying antirheumatic drugs; methotrexate; pulse wave velocity; rheumatoid arthritis

Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

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