If you have rheumatoid arthritis (RA), you need to pay attention.
Top Blood Pressure Facts for People Living With Rheumatoid Arthritis
Fact: People with RA are at heightened risk for cardiovascular disease (CVD). Fact: If you have RA, you actually have less of a chance of being diagnosed with high blood pressure even if you have all the signs. Fact: Within the new, stricter guidelines, even more people with RA are at risk for cardiovascular events, making it even more important that you and your healthcare team assess your blood pressure and manage it if it’s too high.
The Data Behind the New Blood Pressure Guidelines
“Research shows you can reduce your risk of stroke if you can get down to 130/80,” says Christie M. Bartels, MD, assistant professor in the rheumatology division at the University of Wisconsin School of Medicine and Public Health in Madison.
Don’t Fall Into the Healthcare Gap When You Have RA
CVD often occurs in people with RA because of the inflammatory nature of the disease. But: “Additionally, patients may have gaps in preventive care. If three-quarters of their of visits are in a rheumatology clinic, the primary care physician might not be aware that levels have been elevated over time, and rheumatologists may not have blood pressure on their radar,” cautions Dr. Bartels. It’s important to get your primary care physician and rheumatologist working together. Your visits are happening in more than one place, so the results may fall through the cracks, and then the doctors aren’t following a trend.
Know Your Numbers, and the New Numbers
According to the new rules, a reading at or above 130/80 mmHg qualifies as high blood pressure, but to call it hypertension, you need more than one visit. Consistency counts in the determination, but in reality a high blood pressure reading might not be tackled by a physician. New research led by Bartels shows that only one in three visits with high blood pressure by the old guidelines were addressed; follow-up was recommended in only one in ten eligible rheumatology visits.
Don’t Assume Blood Pressure Is Normal if It’s Not Discussed
A study published in April 2016 in the journal Arthritis Care Research,which was led by Bartels, found that many patients assumed their blood pressure was normal if it was not mentioned. Rheumatologists said they might not address blood pressure or would just send a note, assuming primary care would manage it.
Ask for Results Whenever Your Blood Pressure Is Taken
As the American Heart Association urges, it is critical to “Know Your Numbers” — your life may depend on it. “If the nurse doesn’t tell you what your numbers are, ask. Don’t assume it’s normal; it’s not always the case. It’s important to be an empowered patient so you can follow up. Your doctor may assume a one-time reading is just due to nervousness, also known as white coat syndrome,” says Bartels.
A Heart Health To-Do List for People With Rheumatoid Arthritis
To get you on a heart-healthy path:
Make sure your primary care doctor and rheumatologist are working together to ensure proper follow-up care on your blood pressure.Quit smoking.Decrease sodium intake.If you need to lose weight, even a modest loss can help.Exercise frequently.Restrict alcohol intake to two drinks a day or less.If lifestyle changes don’t get you all the way there, discuss medication with your primary care physician, keeping in mind that no one drug works for every patient. You need to be followed so that the medication can be adjusted.
Embrace the Brand New Health Challenge
If you’ve been struggling to reach even the old guidelines, it would be easy to give up and feel, “This is impossible so forget it.” Bartels urges you not to. “Think of this as a new opportunity. You don’t have to do it alone; your doctors are there to work with you. Most people can get there, so don’t give up!”
