Background/Purpose:

The aim of this study was to compare markers of subclinical cardiovascular disease (CVD) in adults with juvenile idiopathic arthritis (JIA) and controls, and assess the relation between arterial properties and JIA characteristics, received therapy, and traditional cardiovascular risk factors.

Methods:

Eighty-seven JIA patients (median age 38.4 years), with persistently active disease at least 15 years after disease onset, registered by longitudinal follow-up, were reexamined after median 29 years and compared to 87 matched controls from the Norwegian population register. Pulse wave velocity (PWV), a direct measure of large arterial stiffness and augmentation index (AIx), a marker of arterial stiffness and wave reflection, were estimated. Linear regression analyses adjusted for age and gender were used to analyze the associations between arterial stiffness and traditional cardiovascular risk factors as well as disease characteristics. Linear multiple regression analyses were performed to identify predictors of arterial stiffness.

Results:

PWV, systolic and diastolic blood pressures (SBP and DBP) were significantly higher in patients than controls (table). In patients, increased PWV was mainly related to DBP (p <0.001), but was also associated with higher SBP (p<0.001), glucose (p=0.001), and pulse rate (p=0.003), lower high density lipoprotein cholesterol (p=0.050), and male gender (p=0.013). Higher AIx was determined by increased DBP (p<0.001), age (p = 0.039), female gender (p < 0.001), daily smoking (p=0.024), high sensitivity C- reactive protein (CRP) (p=0.014), and physician`s global assessment of disease activity (p=0.001). Furthermore, AIx was associated with longer duration of active disease (p=0.012), higher CRP area under the curve (p=0.006), less vigorous physical activity (p=0.004), joint erosions (p=0.016), and therapy with prednisolone (p<0.001), nonsteroidal anti-inflammatory drugs (p=0.036), and methotrexate (p=0.015). Hypertension, daily smokers, and insulin resistance were more frequent in patients than controls (p=0.039, p=0.043 and p=0.034 respectively), but the traditional cardiovascular risk factors were more extensively related to increased AIx in controls.

Conclusion:

JIA patients with long-term active disease experienced increased arterial stiffness assessed by PWV. Traditional cardiovascular risk factors and the degree of disease activity and severity, treatment factors and physical activity influenced the arterial stiffness measured by PWV and AIx in these patients.

Table

	n	JIA patients	Controls	P (paired t-test)
Systolic blood pressure (mmHg)	87	119.4 ± 14.5	115.7 ± 9.8	0.050
Diastolic blood pressure (mmHg)	87	75.7 ± 10.3	72.7 ±  8.2	0.029
Pulse (beats/ minute)	87	62.7 ± 10.7	61.8 ± 9.7	0.564
Pulse wave velocity (PWV) (m/s)	78	7.2 ± 1.0	6.9 ± 0.8	0.035
Augmentation index (AIx)	79	14.5 ± 10.8	12.0 ± 12.2	0.154

 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increased-pulse-wave-velocity-in-juvenile-idiopathic-arthritis-patients-compared-to-controls-from-the-general-population/