Knee Osteoarthritis and Risk of Hypertension: A longitudinal cohort study

Whilst previous research has indicated an association between osteoarthritis and cardiovascular disease, it remains unclear whether people with osteoarthritis are at greater risk of developing hypertension. The aim of this study was to answer this uncertainity. We used the data of the Osteoarhritis Iniative, an ongoing public and private longitudinal study including people at higher risk of osteoarthritis or having knee osteoarthritis. Knee osteoarthritis was defined through radiological and clinical assessment. Incident hypertension was defined as a systolic blood pressure >140 mmHg and/or a diastolic value >90 mmHg. Multivariate Cox's regression analyses were constructed where the presence of knee osteoarthritis as the exposure and incident hypertension as the outcome during a 96 month follow-up interval. A total of 3,558 people with normative blood pressure values at baseline were analyzed (1,930 OA / 1,628 controls). Incidence of hypertension within the follow-up interval was significantly higher in people with knee osteoarthritis compared to those without (60/ vs. 55/1,000 persons/years; p<0.0001). After adjusting for 13 confounders, people with knee osteoarthritis had a 13% higher chance of developing hypertension (Hazard ratio = 1.13; 95%CI: 1.01-1.26, p=0.03). Propensity score analysis did not alter these conclusions. In conclusion, this is the first longitudinal data analysis to demonstrate that people with knee osteoarthritis have a higher chance of developing hypertension compared to those without osteoarthritis. Our data suggests that monitoring blood pressure and prescribing health promotion interventions may be warranted among people with osteoarthritis to mitigate the potential onset and adverse consequences of hypertension.