Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies

Objective: Literature examining the relationship between elevated blood pressure and osteoarthritis (OA) has yielded conflicting results. This study aimed to systematically review the relationship between hypertension and OA in both load-bearing and non-load-bearing joints. Methods: A systematic lit...

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Autores principales:	Kenneth Lo, Manting Au, Junguo Ni, Chunyi Wen
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Hypertension Metabolic syndrome Osteoarthritis Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/97d1b0f45746409d9d433eb02cd7a8a3
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spelling	oai:doaj.org-article:97d1b0f45746409d9d433eb02cd7a8a32021-11-28T04:32:21ZAssociation between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies2214-031X10.1016/j.jot.2021.05.003https://doaj.org/article/97d1b0f45746409d9d433eb02cd7a8a32022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2214031X21000395https://doaj.org/toc/2214-031XObjective: Literature examining the relationship between elevated blood pressure and osteoarthritis (OA) has yielded conflicting results. This study aimed to systematically review the relationship between hypertension and OA in both load-bearing and non-load-bearing joints. Methods: A systematic literature search was performed on Embase, Emcare, MEDLINE and Ovid Nursing Database. The associations between hypertension and OA development in knees, hips and hands were analysed by calculating the odds ratio (OR). Results: A total of 26 studies with 97,960 participants were included. The overall odds of having OA significantly increased in the people with hypertension compared to the normotensive ones (OR = 1.60, 95%CI = 1.33, 1.94). The association of hypertension with OA was detected in knee (OR = 1.62, 95%CI = 1.32, 1.98), not in hand (OR = 1.19, 95%CI = 0.92, 1.53). Moreover, there existed a stronger association of hypertension with radiographic knee OA (OR = 1.89, 95%CI = 1.40, 2.54) than symptomatic knee OA (OR = 1.39, 95%CI = 1.17, 1.65). The association between hypertension and radiographic knee OA remained statistically significant for the studies that adjusted for body mass index (BMI) (OR = 1.42, 95%CI = 1.13, 1.78), and was particularly strong in women (OR = 2.27, 95%CI = 1.17, 4.39). Conclusion: A BMI-independent association between hypertension and radiographic knee OA existed with potential sex variation, which warrants further investigations into the underlying genetic, hormonal and environmental factors.The translational potential of this article: Blood pressure has been reported to link with OA for years ago, however, its contribution to OA is still unclear and conflicted in different reports. This review indicated an intimate relationship between hypertension and structural damages of knee OA, rather than simply chronic joint pain, especially in women. This finding not only provides stronger support for further investigations into the causal risk factor, i.e. hypertension, of OA from tissue level to molecular level, but also putting forward a novel thinking in OA pathogenesis and its therapy strategies. Orthopedic translation: This study further strengthen the association between hypertension and radiographic knee OA. It points in a vascular aetiology hypothesis of OA. It might open up a new avenue for repositioning anti-hypertensive medications for osteoarthritis treatment.Kenneth LoManting AuJunguo NiChunyi WenElsevierarticleHypertensionMetabolic syndromeOsteoarthritisDiseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Translation, Vol 32, Iss , Pp 12-20 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hypertension Metabolic syndrome Osteoarthritis Diseases of the musculoskeletal system RC925-935
spellingShingle	Hypertension Metabolic syndrome Osteoarthritis Diseases of the musculoskeletal system RC925-935 Kenneth Lo Manting Au Junguo Ni Chunyi Wen Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies
description	Objective: Literature examining the relationship between elevated blood pressure and osteoarthritis (OA) has yielded conflicting results. This study aimed to systematically review the relationship between hypertension and OA in both load-bearing and non-load-bearing joints. Methods: A systematic literature search was performed on Embase, Emcare, MEDLINE and Ovid Nursing Database. The associations between hypertension and OA development in knees, hips and hands were analysed by calculating the odds ratio (OR). Results: A total of 26 studies with 97,960 participants were included. The overall odds of having OA significantly increased in the people with hypertension compared to the normotensive ones (OR = 1.60, 95%CI = 1.33, 1.94). The association of hypertension with OA was detected in knee (OR = 1.62, 95%CI = 1.32, 1.98), not in hand (OR = 1.19, 95%CI = 0.92, 1.53). Moreover, there existed a stronger association of hypertension with radiographic knee OA (OR = 1.89, 95%CI = 1.40, 2.54) than symptomatic knee OA (OR = 1.39, 95%CI = 1.17, 1.65). The association between hypertension and radiographic knee OA remained statistically significant for the studies that adjusted for body mass index (BMI) (OR = 1.42, 95%CI = 1.13, 1.78), and was particularly strong in women (OR = 2.27, 95%CI = 1.17, 4.39). Conclusion: A BMI-independent association between hypertension and radiographic knee OA existed with potential sex variation, which warrants further investigations into the underlying genetic, hormonal and environmental factors.The translational potential of this article: Blood pressure has been reported to link with OA for years ago, however, its contribution to OA is still unclear and conflicted in different reports. This review indicated an intimate relationship between hypertension and structural damages of knee OA, rather than simply chronic joint pain, especially in women. This finding not only provides stronger support for further investigations into the causal risk factor, i.e. hypertension, of OA from tissue level to molecular level, but also putting forward a novel thinking in OA pathogenesis and its therapy strategies. Orthopedic translation: This study further strengthen the association between hypertension and radiographic knee OA. It points in a vascular aetiology hypothesis of OA. It might open up a new avenue for repositioning anti-hypertensive medications for osteoarthritis treatment.
format	article
author	Kenneth Lo Manting Au Junguo Ni Chunyi Wen
author_facet	Kenneth Lo Manting Au Junguo Ni Chunyi Wen
author_sort	Kenneth Lo
title	Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies
title_short	Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies
title_full	Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies
title_fullStr	Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies
title_full_unstemmed	Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies
title_sort	association between hypertension and osteoarthritis: a systematic review and meta-analysis of observational studies
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/97d1b0f45746409d9d433eb02cd7a8a3
work_keys_str_mv	AT kennethlo associationbetweenhypertensionandosteoarthritisasystematicreviewandmetaanalysisofobservationalstudies AT mantingau associationbetweenhypertensionandosteoarthritisasystematicreviewandmetaanalysisofobservationalstudies AT junguoni associationbetweenhypertensionandosteoarthritisasystematicreviewandmetaanalysisofobservationalstudies AT chunyiwen associationbetweenhypertensionandosteoarthritisasystematicreviewandmetaanalysisofobservationalstudies
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Association between hypertension and osteoarthritis: A systematic review and meta-analysis of observational studies

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