Comorbidities Including Hypertension Are More Common Among OA Patients

Patients with osteoarthritis (OA) are at a greater risk of suffering from comorbidities compared to the general population, a study suggests.

“The presence of multiple chronic conditions in a single individual causes higher mortality, increased hospitalization, impaired physical and mental health, worse disease outcome, and poorer quality of life. The coexistence of chronic conditions with OA is also very common, especially in the later decades of life. For example, according to the Centers for Disease Control and Prevention, >30% of individuals with diabetes mellitus and heart disease have OA,” the study authors wrote.

To explore this topic further, they conducted a systematic review of studies published in the Medline, PubMed, Embase, and Scopus databases between Jan. 1, 1995, and Dec. 31, 2017. Eligible studies were observational ones of patients with OA and/or non-OA control patients that assessed prevalence or incidence and risk ratio of OA comorbidity (defined as “the presence of any concurrent chronic condition in individuals with OA (as an index disease)”).

Comorbodities More Likely in OA

A total of 42 studies from 16 countries were included for review; 27 were case-only and 15 had non-OA controls for comparison. The mean age ranged from 50.8 years to 76.1 years. OA patients had a greater pooled prevalence of any comorbidity compared to non-OA controls (67% [95% confidence interval (CI), 57% to 74%] vs. 56% [95% CI, 44% to 68%]). The pooled prevalence ratio (PR) for any comorbidity was 1.21 (95% CI, 1.02 to 1.45); the PR increased with the number of comorbidities. For one comorbidity, the PR was 0.73 (95% CI, 0.43 to 1.25); for two, the PR was 1.58 (95% CI, 1.03 to 2.42); and for three or more comorbidities, the PR was 1.94 (95% CI, 1.45 to 2.59).

When assessing patients with OA, the most common chronic conditions were hypertension (50%), dyslipidemia (48%), and back pain (33%). Regarding specific diseases, OA patients were more likely than non-OA patients to have stroke (PR, 2.61; 95% CI, 2.13 to 3.21), peptic ulcer (PR, 2.36; 95% CI, 1.71 to 3.27), and metabolic syndrome (PR, 1.94; 95% CI, 1.21 to 3.12).

The study was published in the July issue of Arthritis Care & Research.

The researchers concluded that “individuals with OA are 1.2 times more likely to have any comorbidity than non‐OA controls and 2.5 times more likely to have ≥3 comorbidities. The comorbidities with the highest increase in risk are stroke, peptic ulcer, hypertension, and depression.” They called for future studies to better understand the correlation and come up with treatment strategies.