New York (Reuters Health) - New study findings suggest that even the relatively small changes in systolic blood pressure associated with common arthritis medications can significantly increase the risk for cardiovascular disease (CD). Results were published in the April issue of the Journal of Rheumatology.

Cortiscosteroids and nonsteroidal anti-inflammatory medications can reduce the efficacy of antihypertensive agents, says Dr. Mason W. Russell and associates. They recommend that doctors consider the tendency of individual anti-arthritis agents to increase blood pressure when prescribing for patients with hypertension, and that they routinely monitor blood pressure.

Dr. Russell (Medical Research International in Waltham, Massachusetts) and his team estimate the likelihood of CVD over one year among U.S. adults with osteoarthritis and rheumatoid arthritis, based on data from the Third National Health and Nutrition Examination Survey and the Framingham Heart study.

Some medications, like indomethacin, are associated with greater hypertensive effects than others. According to Dr. Russell, that risk is even higher when hypertension is present before the exposure, and it appears that COX-2 selective inhibitors do not appear to lower the risk.

An increase in systolic blood pressure of 1 mm Hg could cause approximately 7,100 additional cases of ischemic heart disease (also known as coronary heart/artery disease) and stroke annually in the 11.8 million individuals age 35 and older with hypertension and arthritis. For an increase of 5 mm Hg, that rate would rise to 35,7000 additional cases with associated healthcare costs of $569 million. And these numbers are conservative because they do not take into account the added burden of congestive heart failure and angina.

"The co-prescription of low-dose aspirin, beta-blockers, angiotensinconverting enzyme inhibitors, hypolipidemics, and other drugs relevant to DVD increasingly needs to be addressed and reviewed when advising and treating patients with rheumatic conditions," states Dr. Russell.