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708 FREQUENCY OF HYPERTENSION IN PATIENTS WITH CHRONIC INFLAMMATORY DISEASE S IS UNDERESTIMATED

Objective: Patients with autoimmune diseases (AID) have an increased prevalence of several key classic risk factors such as hypertension (H). Other specific factors such as chronic inflammation and immune activation resulting in oxidative stress. What about the prevalence of H in patients with AID expecially in patients with systemic lupus (SLE)? Design and Method: In this work we evaluated frequency of H among 80 (M:F = 9:71, age 47 ± 5 years) SLE patients. H was defined as blood pressure (BP) ≥140/90mmHg for the general population and ≥130/80mmHg for patients with diabetes or kidney disease. Patients were evaluated for current use of antihypertensive drugs. Estimated glomerular filtration rate (eGFR) was evaluated by Modification of Diet in Renal Disease (MDRD) formula. Results: Detection of H was 65%, eGFR was 61.2 ± 18.5 ml/min/1.73m2, BP 149 ± 14/72 ± 11 mmHg. Of those (52 patients, 65%) only 42% received antihypertensive therapy, but only 20% were optimally controlled. We devided patinets in two groups. Strategies in first group include renin-angiotensin-aldosterone blockade with angiotensin-converting enzyme inhibitor (ACEI) (lisinopril 20 mg/day or perindoril 4 mg/day), second group was without ACEI (CCB, diuretics, beta blockers). After 6 months BP decreased by 10 ± 6/5 ± 3 mmHg in group with ACEI, and 7 ± 5/3 ± 2 mmHg in group without ACEI. In firs group renal function was stabile, in second group (without ACEI) small worsening in eGFR was found. Conclusions: There is a burden of unrecognized H in SLE patients. The use of ACEI as therapies in this high risk population can be usefull in slowing progression of accelerated atherosclerosis.