A latest study, published in Canadian Medical Association Journal (CMAJ), has found that prolonged steroid oral therapy in patients suffering from chronic inflammatory conditions can increase the risk of catching hypertension. The study is unique in a sense that there is no previous study showing an association between hypertension and oral glucocorticoid therapy in inflammatory diseases.
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Teumzghi F. Mebrahtu, Ph.D., an epidemiologist and a research fellow at University of Leeds, School of Medicine and Health, and his colleagues conducted this study in England by assessing the prescription data of 71,642 patients suffering from six chronic type of inflammatory conditions. One of the research group members, Prof. Paul M. Stewart, Ph.D., an endocrinologist and Dean at University of Leeds, School of Medicine and Health, says:
Although steroids are very good in reducing the inflammation and can be helpful in saving many lives, but they can be harmful as well. If patients are kept on higher doses for a longer duration than necessary, high blood pressure can occur which is a major health concern and if remains unattended, stroke, heart-disease or even premature death can occur.
The records were collected from 389 practices in England during 1998-2017. All the cases had no previous history of hypertension but were suffering from one of the six conditions like IBD, rheumatoid arthritis, vasculitis, lupus polymyalgia and arteritis. Prescription data for patients who were on oral steroid prednisolone therapy for at least one year was analyzed and link between increased prednisolone dose and probable hypertension was established.
The chances of acquiring hypertension were greater in patients who took oral steroids for longer duration or in higher doses. It was recorded that 34.8% of the total patients developed hypertension within a span of 6.6 years after therapy. It was concluded that the blood pressure of the patients on oral steroidal drugs should be monitored regularly as there is an increased incidence of developing hypertension. However, this study has some limitations as it fails to provide some evidence of glucocorticoid use data in patients during the tapering and after stoppage of medication period.
Chronic inflammatory conditions like rheumatoid arthritis and inflammatory bowel disease (IBD) usually require long term therapy with steroidal anti-inflammatory drugs like prednisolone and other oral glucocorticoids and also with higher doses.