FREQUENT SELF-ASSESSMENTS PROMOTED TREAT-TO-TARGET FOR RA VIA EMPOWERING PATIENTS: A COHORT STUDY FROM CHINA BY SMART SYSTEM OF DISEASE MANAGEMENT (SSDM)

Background: Nocturnal hypertension (HTN) and non-dipping profile are important predictors of adverse cardiovascular (CV) outcomes. Their associations with subclinical vascular damage in rheumatoid arthritis (RA) are still a matter of investigation. It was shown that 10-year atherosclerotic CV disease risk (rASCVD) may be more accurate in CV risk prediction in RA than SCORE. Associations of impaired 24-h BP phenotypes with CV risk in RA are not well-studied yet. Objectives: To assess dipping patterns and nighttime systolic blood pressure (SBPn) and their associations with arterial stiffness and CV risk assessed by rASCVD in patients with RA. Methods: Study group included 90 patients with RA (females 78.7%, age 59.5±14.2 years, HTN 64%, median (med) HTN duration 6.4 years, RA duration – 7.2 years, seropositive RA 66%, mean DAS-28(CRP) 3.8±1.0) and control group (45 patients matched by gender, age and risk factors). All patients with HTN received antihypertensive therapy. Office BP was measured with a validated oscillometric device, 24-hour ABPM was performed with BPLab Vasotens, carotid-femoral PWV was assessed by applanation tonometry. 3 groups were formed after adjustment of dipping state by SBPn: dippers (G1), non-dippers with SBPn Results: Median rASCVD was 6.3%. Rate of BP control was 60% in RA and 66% in the controls (p=0.5). Patients with RA vs controls had higher mean SBPn (124±16 vs 110±8 mmHg, p=0.003), lower diurnal index (DI) (med 3.8 vs 8.1%, p=0.02), higher rate of night HTN (49.6 vs 12.2% (p=0.0002). The RA and control groups didn`t differ by dipping patterns, although RA patients more often had non-dipping profile (DI Conclusion: Patients with RA had higher incidence of non-dipping pattern and SBPn elevation. Combination of high SBPn and non-dipping was associated with higher arterial stiffness and CV risk – this may be mediated by inflammation. Higher CV risk was associated with masked and night HTN. This may help in defining indications for ABPM in this population. References: Hamamoto K. et al. Association of Nocturnal Hypertension With Disease Activity in Rheumatoid Arthritis. Am J Hypertens 2016;29(3):340-7 Ozen G et al. The 2013 ACC/AHA 10-year atherosclerotic cardiovascular disease risk index is better than SCORE and QRisk II in rheumatoid arthritis: is it enough? Rheumatology 2016;55:513 522 Acknowledgments: The publication was prepared with the support of the “RUDN University program 5-100”. Disclosure of Interests: Elena Troitskaya: None declared, Sergei Velmakin: None declared, Svetlana Villevalde Speakers bureau: Servier, Novartis, Boehringer Ingelheim, AstraZeneca, Takeda, Zhanna Kobalava Speakers bureau: Servier, Novartis, Bayer Boehringer Ingelheim, AstraZeneca, Takeda