Cumulative doses of oral steroids linked to increased blood pressure

Cumulative doses of oral steroids in patients with chronic inflammatory diseases are associated with increased hypertension (blood pressure) for those who take them regularly, found new research in CMAJ (Canadian Medical Association Journal).

"The cumulative effect of oral steroid doses on hypertension is substantial, and given that these are commonly prescribed medications, the related health burden could be high," says Dr. Mar Pujades-Rodriguez, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom.

Hypertension, or high blood pressure, affects one in five adults around the world and can have significant negative health effects. Previous studies have reported a dose-related response between oral steroids and hypertension, although evidence has been inconclusive.

This study of more than 71 000 patients from 389 general practices in England looked at the relationship between oral glucocorticoid doses and hypertension in patients with chronic inflammatory diseases between 1998 and 2017. The most common underlying diseases included inflammatory bowel disease (35%) and rheumatoid arthritis (28%). Researchers found that in the cohort studied, there were 24 896 (35%) new cases of hypertension. When patients reached cumulative doses, rates of hypertension increased accordingly in a dose-response pattern.

The authors recommend that health care providers closely monitor blood pressure in patients who routinely take oral steroids.