State of Blood Pressure in Children with Juvenile Rheumatoid Arthritis

Abstract

Children with juvenile rheumatoid arthritis (JRA) has increased risk for pathological changes of blood pressure (BP) due to development of endothelial dysfunction, increase in vascular wall stiffness and treatment with systemic glucocorticosteroids (GCS) treatment. The objective of our study was to study BP characteristic in children with JRA. We examined 31 children, 15 (48.8 %) of them with polyarthritis, 12 (38.7 %) with oligoarthritis and 4 (12.5 %) with systemic form. 21 patient received GCS in mean dose 9 mg/day. The results of examination (office BP measurement, ambulatory BP monitoring, ankle-brachial index (ABI) and evaluation of vegetative status using cardiointervalogram and Veyn questionnaire) showed increased office systolic BP (SBP), average SBP, blood pressure load, morning blood pressure surge and number of non-dipper in sick children, reduction of ABI as compared with healthy children. When JRA, it is revealed the changes in nature of dependence between BP and height and age, which is common for healthy children, toward greater influence of age on the level of the indicator due to the development of short stature. The duration of GCS influenced some indicators. Significant differences in the characteristics of the vegetative status of sick and healthy children were not detected. Conclusion: in children with JRA, there are pathological BP changes, which requires prompt diagnosis and treatment.

Keywords

• juvenile rheumatoid arthritis
• arterial hypertension
• office blood pressure measurement
• ambulatory monitoring