Ankylosing Spondylitis Is Associated with Increased Prevalence of Left Ventricular Hypertrophy

J Rheumatol. 2018 Aug;45(9):1249-1255. doi: 10.3899/jrheum.171124. Epub 2018 Jun 1.

Abstract

Objective: Ankylosing spondylitis (AS) is associated with increased risk for cardiovascular disease (CVD). Left ventricular (LV) hypertrophy is a strong precursor for clinical CVD. The aim of our study was to assess whether having AS was associated with increased prevalence of LV hypertrophy.

Methods: Clinical and echocardiographic data from 139 AS patients and 126 age- and sex-matched controls was used. LV mass was calculated according to guidelines and indexed to height2.7. LV hypertrophy was considered present if LV mass index was > 49.2 g/m2.7 in men and > 46.7 g/m2.7 in women.

Results: Patients with AS were on average 49 ± 12 years old, and 60% were men. The prevalence of hypertension (HTN; 35% vs 41%) and diabetes (5% vs 2%) was similar among patients and controls, while patients with AS had higher serum C-reactive protein level (CRP; p < 0.001). The prevalence of LV hypertrophy was higher in patients with AS compared to controls (15% vs 6%, p = 0.01). In multivariable logistic regression analysis, having AS was associated with OR 6.3 (95% CI 2.1-19.3, p = 0.001) of having LV hypertrophy independent of the presence of HTN, diabetes, and obesity. In multivariable linear regression analyses, having AS was also associated with higher LV mass (β 0.15, p = 0.007) after adjusting for CVD risk factors including sex, body mass index, systolic blood pressure, diabetes, and serum CRP (multiple R2 = 0.41, p < 0.001).

Conclusion: Having AS was associated with increased prevalence of LV hypertrophy independent of CVD risk factors. This finding strengthens the indication for thorough CVD risk assessment in patients with AS.

Keywords: ANKYLOSING SPONDYLITIS; ECHOCARDIOGRAPHY; HYPERTENSION; LEFT VENTRICULAR HYPERTROPHY.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Body Mass Index
  • Comorbidity
  • Echocardiography
  • Female
  • Humans
  • Hypertension / diagnostic imaging
  • Hypertension / epidemiology*
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / epidemiology*
  • Hypertrophy, Left Ventricular / physiopathology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sex Factors
  • Spondylitis, Ankylosing / diagnostic imaging
  • Spondylitis, Ankylosing / epidemiology*
  • Spondylitis, Ankylosing / physiopathology