Uveitis is associated with hypertension and atherosclerosis in patients with ankylosing spondylitis: A cross-sectional study

• Published in: Seminars in arthritis and rheumatism Vol. 44; no. 3; pp. 309 - 313
• Main Authors: Berg, Inger Jorid, MD, Semb, Anne Grete, MD, PhD, van der Heijde, Désirée, MD, PhD, Kvien, Tore K., MD, PhD, Hisdal, Jonny, PhD, Olsen, Inge C., PhD, Dagfinrud, Hanne, PhD, Provan, Sella A., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2014
• Subjects: Adult; Ankylosing spondylitis; Atherosclerosis - epidemiology; Cardiovascular disease; Cross-Sectional Studies; Disease activity; Female; Humans; Hypertension; Hypertension - epidemiology; Male; Middle Aged; Multivariate Analysis; Prevalence; Regression Analysis; Rheumatology; Risk Factors; Severity of Illness Index; Spondylitis, Ankylosing - complications; Uveitis; Uveitis - complications; Uveitis - epidemiology; Uveitis - etiology; Hypertension; Cardiovascular disease; Disease activity; Ankylosing spondylitis; Uveitis
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2014.05.017

Abstract Objectives Uveitis is the most common extra-articular manifestation in patients with ankylosing spondylitis (AS), but the literature describing AS patients with a history of uveitis is limited. The objective was to examine if a history of uveitis in patients with AS is associated with increased disease activity and functional impairment and to investigate whether uveitis is associated with an increased frequency of cardiovascular comorbidities, defined here as hypertension and atherosclerosis. Methods Data were recorded cross-sectionally through patient interviews, blood samples, clinical examination, and questionnaires. Carotid plaques were identified by ultrasonography. AS disease activity and function were compared across categories of uveitis using ANCOVA analyses. Associations between uveitis and hypertension and atherosclerosis [atherosclerotic cardiovascular disease (CVD) and/or carotid plaque] were analyzed in multivariate logistic regression models. Results Of 159 patients with AS (61.6% male, mean age 50.5 years), 84 (52.8%) had experienced one or more episodes of uveitis. AS disease activity was higher in patients with a history of uveitis, statistically significant for functional impairment [Bath AS Functional Index (BASFI)] [mean difference (95% CI)] lnBASFI = 0.2 (0.0–0.3), p = 0.05. Patients with uveitis had an increased odds ratio [OR (95% CI)] for hypertension [3.29 (1.29–8.41), p = 0.01] and atherosclerosis [2.57 (1.15–5.72), p = 0.02]. Conclusions AS patients with a history of uveitis had non-significantly higher disease activity and significantly higher functional impairment. A history of uveitis was associated with hypertension as well as atherosclerosis. These results may be important in identifying AS patients with elevated risk of CVD but should be confirmed in longitudinal cohorts.