ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2020
Oral glucocorticoids and incidence of hypertension in people with chronic inflammatory diseases: a population-based cohort study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- British Society of Gastroenterology guidelines for diagnosis and management of autoimmune hepatitis.Gut · 2025Guideline
- Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus.Current rheumatology reviews · 2025Guideline
- Metabolic adverse events associated with systemic corticosteroid therapy-a systematic review and meta-analysis.BMJ open · 2022Pooled it
- Systemic administration of glucocorticoids, cardiovascular complications and mortality in patients hospitalised with COVID-19, SARS, MERS or influenza: A systematic review and meta-analysis of randomised trials.Pharmacological research · 2022Pooled it
- Balancing inflammation under stress: glucocorticoid regulation of innate immune pathways.Bioscience reports · 2026Review
- A Drug-Environment Interaction Between PMPharmacoepidemiology and drug safety · 2026Article
- The roles, mechanisms, and therapeutic implications of glucocorticoids in glucose and lipid metabolism.Military Medical Research · 2026Review
- A controlled comparative study of the effects of methotrexate and pharmacogenetic factors on arterial blood pressure and arterial stiffness in patients with rheumatoid arthritis.Annals of medicine · 2025Article
- Pathophysiological Links Between Inflammatory Bowel Disease and Cardiovascular Disease: The Role of Dysbiosis and Emerging Biomarkers.Biomedicines · 2025Review
- High-Dose Steroids, Treatment Escalation, and Healthcare Burden in Myasthenia Gravis: A US Claims-Based Cohort Study.Neurology and therapy · 2025Article
- The Cardiovascular Safety of Tumour Necrosis Factor Inhibitors in Arthritic Conditions: A Structured Review with Recommendations.Rheumatology and therapy · 2025Review
- Efficacy and Side Effect of Different Doses of Glucocorticoids on Sudden Deafness.Current therapeutic research, clinical and experimental · 2025Article
- Serum Cortisol and Cardiovascular Disease Risk - A Potential Biomarker.Current cardiology reviews · 2025Review
- Glucocorticoid chronopharmacology promotes glucose metabolism in heart through a cardiomyocyte-autonomous transactivation program.JCI insight · 2024Article
- Modelling Adverse Events in Patients Receiving Chronic Oral Corticosteroids in the UK.PharmacoEconomics - open · 2024Article
- Management of a Patient with Cardiovascular Disease Should Include Assessment of Primary and Secondary Immunodeficiencies: Part 2-Secondary Immunodeficiencies.Healthcare (Basel, Switzerland) · 2024Review
- Oral Corticosteroids for Skin Disease in the Older Population: Minimizing Potential Adverse Effects.Drugs & aging · 2024Review
- Glucocorticoid chrono-pharmacology unveils novel targets for the cardiomyocyte-specific GR-KLF15 axis in cardiac glucose metabolism.bioRxiv : the preprint server for biology · 2024Article
- More efficient adaptation of cardiovascular response to repeated restraint in spontaneously hypertensive rats: the role of autonomic nervous system.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Prevalence and contributing factors of metabolic syndrome in rheumatoid arthritis patients.BMC endocrine disorders · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundOnly a few population-based studies have examined the association between glucocorticoids and hypertension, with inconsistent results. We aimed to investigate the effect of oral glucocorticoids on incidence of hypertension in adults with chronic inflammatory diseases.
methodsWe analyzed electronic health records from 389 practices in England during 1998-2017 of adults diagnosed with any of 6 chronic inflammatory diseases but with no previous diagnosis of hypertension. We used glucocorticoid prescription data to construct time-variant daily and cumulative variables of prednisolone-equivalent dose (cumulated from 1 year before the start of follow-up) and estimated incidence rates and adjusted hazard ratios (HRs) for hypertension using Cox regression analysis.
resultsAmong 71 642 patients in the cohort, 24 896 (34.8%) developed hypertension during a median follow-up of 6.6 years. The incidence rate of hypertension was 46.7 (95% confidence interval [CI] 46.0-47.3) per 1000 person-years. Incidence rates increased with higher cumulative glucocorticoid prednisolone-equivalent dose, from 44.4 per 1000 person-years in periods of nonuse to 45.3 per 1000 person-years for periods with between > 0.0 and 959.9 mg (HR 1.14, 95% CI 1.09-1.19), to 49.3 per 1000 person-years for periods with 960-3054.9 mg (HR 1.20, 95% CI 1.14-1.27), and to 55.6 per 1000 person-years for periods with ≥ 3055 mg (HR 1.30, 95% CI 1.25-1.35). Cumulative effects were seen for the 6 diseases studied, but dose-response effects were not found for daily dose.
interpretationCumulative dose of oral glucocorticoids was associated with increased incidence of hypertension, suggesting that blood pressure should be monitored closely in patients routinely treated with these drugs. Given that glucocorticoids are widely prescribed, the associated health burden could be high.
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