Issue: 2025, Vol. 30, No. 1

S. E. Myasoedova, E. S. Poltyreva

BLOOD PRESSURE IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING REHABILITATION

Keywords

rheumatoid arthritis, hypertension, daily blood pressure monitoring, aerobic exercise

Abstarct

The objective is to study the dynamics of blood pressure (BP) through the daily monitoring (BPDM) in patients with rheumatoid arthritis (RA) during complex rehabilitation including aerobic exercise. Materials and Methods. 127 patients with RA (ACR/EULAR, 2010) [13], 118 women and 9 men, the average age being 61.4 ± 10.7 years old, were examined. The investigation complex at the admission included BPDM, assessment of the Disease Activity Score (DAS28), pain by the Visual Analog Scale (VAS), hand strength, Health Assessment Questionnaire Disability Index (HAQ) and the 6-minute walk test (6MWT). Control measurements were carried out in dynamics two weeks after the rehabilitation course completion, which included physical therapy to strengthen muscles and increase joint mobility, aerobic exercise on cardio equipment and physiotherapy as well as educational programs for patients. Results and Discussion. The rehabilitation activity significantly decreases the daytime systolic (SBP) and diastolic blood pressure (DBP), the daytime BP-index in the general group of RA patients and in patients having RA with both previously established (n = 87) and newly diagnosed “masked” (n = 14) hypertension, no marked changes in patients with RA without hypertension (n = 26) being observed. Moreover, DAS28 and VAS pain decreased (p = 0.00 and p = 0.001), the compressive strength of the right and left hands grew (p = 0.00 and p = 0.007), the distance in the 6MWT was enlarged (p = 0.00) and the functional ability by HAQ was improved. ‘Non-dipper’ and ‘night-peake’ patients taking selective nonsteroidal anti-inflammatory drugs (s-NSAIDs) prevailed before and after rehabilitation compared to ‘dipper’ type patients. Conclusion. Complex rehabilitation of RA patients including aerobic exercise has a beneficial effect on the indicators of BPDM with and without hypertension, the indicators of RA activity and functional abilities of patients. A stable profile of BPDM during rehabilitation in patients with insufficient decrease of nocturnal BP or its increase requires BPDM monitoring and correcting antihypertensive therapy, especially in the group of patients taking s-NSAIDs.

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• Vestnik_1_2025-11-17