Systolic blood pressure is a useful measure in predicting the risk of endothelial dysfunction in patients with rheumatoid arthritis

Whether risk factors exert more-important roles in the development of cardiovascular disease (CVD) with rheumatoid arthritis (RA) is unclear. We investigated traditional and non-traditional risk factors for coronary artery disease (CAD) in relation to endothelial function and ascertained which measure was a better screening strategy for assessing the risk of endothelial dysfunction in patients with RA. Forty-three RA patients were divided into either a normal (n = 29) or an abnormal (n = 14) endothelial function group based on the measurement of flow-mediated vasodilation. Thirty-three CAD patients were recruited from among cardiology clinic outpatients. Traditional (i.e., smoking, drinking, systolic and diastolic blood pressures, and lipid profiles) and non-traditional risk factors (i.e., inflammatory and immune responses, plasma homocysteine, and deficiency of B vitamins) for CVD were recorded or measured. Systolic blood pressure was significantly higher and was associated with abnormal endothelial function in RA patients (n = 20.7, p < 0.01) and CAD patients (n = 20.6, p < 0.01) than RA patients with normal endothelial function after adjusting for various potential confounders. Systolic blood pressure had the highest area under the receiver operating characteristic curve (AUC) (AUC = 0.80, 95% confidence interval, 0.65∼0.94) for predicting the risk of endothelial dysfunction. The optimal cutoff value for systolic blood pressure to determine a risk of endothelial dysfunction was 112 mmHg. Systolic blood pressure could be a practical tool to screen for risks of endothelial dysfunction in patients with RA. Patients with RA should try to control their blood pressure in order to reduce the risk of CAD.