Initially, it may appear that high blood pressure and osteoarthritis are unrelated; however it is more than a coincidence that many individuals are diagnosed with both conditions. Both are inflammatory conditions (Fernandes, 2015). The relationship between osteoarthritis and hypertension is impacted by direct and indirect factors.
Obesity, High Blood Pressure, and Osteoarthritis
It’s well known that people who are overweight are more likely to have a diagnosis of high blood pressure than individuals who are thin or maintain a healthy weight. Individuals who are overweight or obese are often diagnosed with osteoarthritis which is caused by excessive pressure on their joints. The joints become inflamed and wear out. In these cases, healthcare providers need to encourage patients to lose weight in order to maintain the health of their bones and other connective tissues.
Arthritic Pain and Stress May Elevate Blood Pressure
Individuals who have osteoarthritis often suffer from joint pain and stress. Pain causes blood pressure to rise. Anxiety over a lack of independence and fears about debility may arise. Individuals who have severe osteoarthritis may require joint replacement surgery. Therefore, worries about surgery, finances, rehabilitation, and becoming incapacitated contribute to blood pressure elevation. For most individuals, the increase in blood pressure is slight. However, for individuals who have severe pain, anxiety, or hard-to-control hypertension, an elevation in blood pressure may precipitate life-threatening health conditions.
Non-steroidal anti-inflammatory medications, NSAIDs, are the most common medications used to treat individuals who are diagnosed with osteoarthritis. The use of NSAIDs can also directly affect blood pressure readings (Aljadhey, 2012). If the medications relieve pain effectively, they may cause the blood pressure to remain within normal limits. However, NSAIDs may cause hypertension.
Hypertension may result from two actions of the NSAIDs. Some NSAIDs reduce the effectiveness of medications which are used to treat hypertension. NSAIDS may cause sodium retention and as a result, fluids are retained and the blood pressure rises.
High Blood Pressure, Arthritis, and Diabetes
Researchers in Germany discovered that the most common comorbidities that people with diabetes have are hypertension and osteoarthritis. While having high blood pressure does not directly impede the quality of life among the study participants, a diagnosis of osteoarthritis resulted in more frequent medical treatments, higher levels of discomfort, and increased debility (Miksch, 2009).
Individuals who suffer from diabetes have higher rates of obesity than the general population. Due to this, they are more likely to suffer from surgical complications should joint replacement be needed.
The Bottom Line
It is important that healthcare providers be aware that individuals who suffer from diverse health challenges, such as hypertension and obesity, be aware of the relationship between the conditions. The public needs to be educated about risks and taught strategies which minimise the symptoms of osteoarthritis and hypertension. Healthcare providers need to be aware of the need for holistic treatments that reduce stress and pain. Individuals who have diabetes must be taught how to manage their blood pressure and maintain the health of their joints. It is essential that the risks and benefits of medications be evaluated when employing pharmaceuticals to manage arthritis symptoms. A holistic approach, which emphasises wellness, is likely to be the most effective way to prevent and manage the symptoms of hypertension and osteoarthritis.
- Antje Miksch, Katja Hermann, Andreas Rölz, Stefanie Joos, Joachim Szecsenyi, Dominik Ose, and Thomas Rosemann. Additional impact of concomitant hypertension and osteoarthritis on quality of life among patients with type 2 diabetes in primary care in Germany – a cross-sectional survey. Health Qual Life Outcomes. 2009; 7: 19. Published online 2009 Feb 27. doi: 10.1186/1477-7525-7-19.
- Fernandes GS, Valdes AM. Cardiovascular disease and osteoarthritis: common pathways and patient outcomes. Eur J Clin Invest. 2015 Jan 29. doi: 10.1111/eci.12413. [Epub ahead of print].
- Hisham Aljadhey Wanzhu Tu, Richard A Hansen, Susan J Blalock, D Craig Brater, and Michael D Murray. Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2012; 12: 93.Published online 2012 Oct 24. doi: 10.1186/1471-2261-12-93.
- Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T. Mutual associations among musculoskeletal diseases and metabolic syndrome components: A 3-year follow-up of the ROAD study. Mod Rheumatol. 2014 Nov 20:1-11. [Epub ahead of print].