Associated Factors of Hypertension and Hyperglycemia Related to Steroid Pulse in Autoimmune Diseases

Eduardo Saul Acevedo-Castañeda¹, Marco Ulises Martinez-Martinez², David Herrera Van Oostdam³, Carlos Abud-Mendoza⁴, Homero López-Ferretis⁵, Angel Javier Pedro Martínez⁵, Dolores Ramos-Bello⁶, Tania Adriana Luna-Zúñiga⁵, Georgina Aguilera Barragán-Pickens⁵ and Georgina Martínez-Flores⁵, ¹Medicina Interna, Unidad Regional de Reumatologia y Osteoporosis Hospital Central "Dr. Ignacio Morones Prieto" y Facultad de Medicina de la UASLP, San Luis Potosí, Mexico, ²Unidad de Investigaciones Reumatológicas, Faculty of Medicine, Universidad Autónoma de San Luis Potosí and Hospital Central, San Luis Potosí, Mexico, ³Unidad de Investigaciones Reumatológicas, Hospital Central & Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico, ⁴Unidad de Investigaciones Reumatológicas y Osteoporosis, Faculty of Medicine, Universidad Autónoma de San Luis Potosí and Hospital Central, San Luis Potosí, Mexico, ⁵Unidad Regional de Reumatologia y Osteoporosis Hospital Central "Dr. Ignacio Morones Prieto" y Facultad de Medicina de la UASLP, San Luis Potosí, Mexico, ⁶Reumatología, Unidad Regional de Reumatologia y Osteoporosis Hospital Central "Dr. Ignacio Morones Prieto" y Facultad de Medicina de la UASLP, San Luis Potosi, Mexico

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: complications, hypertension and steroids

Session Information

Date: Tuesday, November 7, 2017

Title: Rheumatoid Arthritis – Clinical Aspects Poster III: Comorbidities

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

–Background/Purpose: Steroid pulses are widely used in treatment for multiple inflammatory pathologies. The prevalence of hyperglycemia is 55-98%, and hypertension 5-52.5%. (1-2); safety profile could be different according glucocorticoid used and doses. Information at this topic is limited, and the development factors unknown.

–Methods: This was a retrospective cohort study, single-hospital. Participants were patients treated with steroid pulse in the last 10 years due to autoimmune diseases. Data was obtained from medical records: demographic data, capillary glycaemia and blood pressure. Data analysis were performed with R Commander V2.3-1. A bivariate analysis was performed between patients with and without hyperglycemia or hypertension for categorical variables test X2/ exact Fisher, for continuous variables parametric/no parametric tests as corresponded. In multivariate logistic regression model to assess independent factors for uncontrolled hypertension or blood glucose, as well as mixed models.

-Results: We included 171 patients, 156 received methylprednisolone and 15 dexamethasone. Logistic Regression identified previous diabetes (p = 0.0001) and use of fractional doses (p = 0.03), were factors associated with hyperglycemia. In hypertension male patients were less likely to develop this event (OR 0.43, IC95% 0.2-0.89, p 0.02). Patients who received methylprednisolone were less likely to develop diastolic hypertension (OR 0.28, 95% 0.06-1, p 0.03).

-Conclusion: The prevalence of hyperglycemia and hypertension was 53 and 42% respectively. Single-dose pulse therapy and methylprednisolone were protective factors. Age, female, prior diabetes mellitus or hypertension and creatinine level were associated as risk factors.

-References: 1. Miura M, Ohki H, et al. Adverse effects of methylprednisolone Kawasaki press therapy in refractory disease. Arch Dis Child. 2005; 90: 1096-7.

2. Tamez Perez HE, et al. Glucose disturbances in non-diabetic patients receiving acute treatment with methylprednisolone pulses. Rev Assoc Med Bras. 2012; 58: 125-8

Disclosure: E. S. Acevedo-Castañeda, None; M. U. Martinez-Martinez, None; D. Herrera Van Oostdam, None; C. Abud-Mendoza, Bristol-Myers Squibb, Pfizer Inc, Roche, 5,Bristol-Myers Squibb, Merck-Serono, Pfizer Inc, Roche, UCB, 8; H. López-Ferretis, None; A. J. Pedro Martínez, None; D. Ramos-Bello, None; T. A. Luna-Zúñiga, None; G. Aguilera Barragán-Pickens, None; G. Martínez-Flores, None.

To cite this abstract in AMA style:

Acevedo-Castañeda ES, Martinez-Martinez MU, Herrera Van Oostdam D, Abud-Mendoza C, López-Ferretis H, Pedro Martínez AJ, Ramos-Bello D, Luna-Zúñiga TA, Aguilera Barragán-Pickens G, Martínez-Flores G. Associated Factors of Hypertension and Hyperglycemia Related to Steroid Pulse in Autoimmune Diseases [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/associated-factors-of-hypertension-and-hyperglycemia-related-to-steroid-pulse-in-autoimmune-diseases/. Accessed .

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