RISK OF DEVELOPING HYPERTENSION IN ADULTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Objective: To determine the relation between systemic lupus erythematosus (SLE) and incidence of hypertension Design and method: Nationwide retrospective study of adults (aged over 18 years) was conducted using Polish public payer claims database. Patients considered to have hypertension have to meet inclusion criteria defined as at least one reporting of the ICD-10 code from I10 to I15 in medical history from specialist outpatient clinic or hospital or at least two reports of I10 to I15 code from primary care. Risk of developing hypertension in relation to sex, age, the occurrence of SLE, kidney diseases, diabetes, cancer diseases, asthma and chronic obstructive pulmonary disease (COPD) was analyzed using a multivariable Cox proportional hazard model. Results: Cohort of 19,13 mln patients without hypertension on 31st December 2019 was identified in payer database and enrolled to study. During a median follow-up of 2.98±0,23 years, 955 614 patients developed hypertension (51.2% of them was male). The incidence of hypertension was 8.8% (2.9% per 12 months) in patients with SLE and 5.0% (1.7% per 12 months) in patients without SLE. The univariable hazard ratio related to the presence of SLE was 1.80 (95% confidence intervals [CI]: 1.71-1.91), while multivariable was 1.71 (95% CI: 1.61-1.81). The multivariate hazard ratio related to SLE was 2.53 (95%CI: 2.25-2.85) in patients aged 18-40 years (n = 10 843 572; 56.7%), 1.35 (95%CI: 1.25-1.44) in patients aged 41-65 years (n = 7 159 253; 37.4%) and 1.27 (95%CI: 1.09-1.49) in those at the age above 65 years (n = 1 123 675; 5.9%). During the study period 151 (10.8%) men and 1061 (8.6%) women with SLE developed hypertension. The multivariate hazard ratio related to SLE was 1.73 (95%CI: 1.47-2.03) in men and 1.48 (95%CI: 1.39-1.57) in women. Conclusions: Systemic lupus erythematosus increases the risk of developing hypertension, especially in young adult population aged 18-40. The risk for future hypertension is higher in men with SLE compared to women with SLE.