Is hypertension associated with arthritis? The United States national health and nutrition examination survey 1999–2018

OBJECTIVE: Hypertension and arthritis are two common diseases in the general population, with multiple common risk factors. This study aimed to assess the association between hypertension (HTN) and arthritis. PATIENTS AND METHODS: This cohort study included 48,372 eligible non-pregnant participants aged ≥ 20 years who had valid data on hypertension and arthritis from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. The association between hypertension and arthritis was studied by logistic regression, adjusting for demographics, socioeconomic factors, excess sodium intake, physical activity, ever smoking, diabetes status and body mass index (BMI). RESULTS: Among the participants, 48.0% (95% CI: 47.2–48.9) had hypertension and 24.5% (95% CI: 23.8–25.3) had self-reported arthritis. Hypertension was associated with arthritis [OR = 2.90, (95% CI: 2.74–3.07), p < 0.01], which remained significant [OR = 1.27, (95% CI:1.18–1.37), p < 0.01] after adjustments. Stratified by the types of arthritis, the association remained significant in rheumatoid arthritis (RA) [OR = 1.25, (95% CI: 1.11–1.41), p < 0.01] and osteoarthritis (OA) [OR = 1.32, (95% CI: 1.16–1.50); p < 0.01]. There was no clear association between hypertension and OA in participants aged 60 years old and above [OR = 1.08, (95% CI: 0.92–1.26); p = 0.37]. CONCLUSIONS: In this large nationally representative survey over 20 years, arthritis, including both RA and OA, was strongly associated with hypertension. Our study demonstrates a need for hypertension screening and blood control among patients with arthritis. KEY MESSAGES: Arthritis was associated with hypertension. Both rheumatoid arthritis and osteoarthritis are strongly associated with hypertension. There is an urgency for hypertension screening and blood control among patients with arthritis.