Highlights
- •Corticosteroids are known to cause hypertension with long-term use.
- •Short pulse, high dose corticosteroids are used for relapse treatment in multiple sclerosis and there has been limited investigation of the impact of this treatment on blood pressure.
- •In our study group, there was a blunting in the normal nocturnal dip in blood pressure and evidence of nocturnal hypertension.
- •Subjects with a personal or family history of hypertension had higher daytime systolic blood pressure readings.
- •In light of these findings, clinicians may consider more monitoring for patients requiring high dose corticosteroids who have a history of hypertension.
Abstract
Background
Multiple sclerosis (MS) relapses are often treated with short pulses of high dose
corticosteroids. Previous literature demonstrates corticosteroids can increase blood
pressure (BP). There are few studies regarding effects of high dose, pulse corticosteroids
on BP when treating MS relapses.
Objective
To investigate the effect of high dose pulse corticosteroids for MS relapses on BP
and determine factors that may influence development of acute hypertension.
Methods
In this open-label pilot study, adult patients with a diagnosis of MS were enrolled
if determined to be having a relapse that would meet criteria for corticosteroid treatment.
BP was monitored sequentially over the course of their corticosteroid treatment and
correlations were made with demographic data, including past medical and family history.
Results
22 subjects contributed data. Higher daytime BP was noted in subjects with a past
personal (p = 0.007) or family history of hypertension (p = 0.037). Nighttime BP recordings did not show the normal 10% drop and nocturnal
diastolic BP was within a hypertensive range during corticosteroid treatment.
Conclusion
MS patients may be at risk of increased BP when treated with corticosteroids for relapses.
Those with a past or family history of hypertension may be at higher risk and may
warrant more frequent monitoring.
Keywords
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Article info
Publication history
Published online: July 14, 2020
Accepted:
July 14,
2020
Received in revised form:
July 13,
2020
Received:
June 1,
2020
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier B.V. All rights reserved.
