Clinical Analysis On Primary Knee Osteoarthritis Combined With Hypertension In Elderly Patients

Background and aims:Osteoarthritis(OA) is among the most frequent and debilitating arthritic conditions in aging people. However, the mechanisms underline the onset and progressions of the disease remain unclear. Knee joint is one of the organs most frequently involved in OA. Arterial hypertension is one common cardiovascular disorder characterized by continuous high blood pressure. Epidemiologic studies have shown that hypertension occurs more often in patients with OA than those without OA. Currently the causal relationship between knee OA(KOA) and hypertension still remains unclear. Our study aims to explore whether hypertension is significantly related to joint function of KOA and reveal some factors involved in this effect. Materials and Methods:Clinical data of KOA patients combined with hypertension were analyzed retrospectively. All patients were severe KOA and admitted to the Second affiliated hospital of Shanxi Medical College between January to May in 2014, who will undergo total knee arthroplasty. Clinical data includes 1) general information, e.g. gender, age, height, body weight, blood pressure and number of knee joints with OA), 2) systemic blood test for blood cytology, biochemistry, coagulative and fibrinolytic activity, C-reactive protein(CRP) and erythrocyte sedimentation rate(ESR), 3) X-ray to evaluate knee joint severity and measure bone mineral density(BMD) values, 4) calculation of body mass index(BMI), 5) Hospital for Special Surgery(HSS) Score to evaluate knee function. Results:Totally 104 cases of primary KOA were included, among which 61 cases combined with hypertension and 43 cases shown as simple KOA. Our study revealed that HSS score was significantly lower in hypertension KOA that in simple KOA. And female KOA showed even lower HSS score than control while there was no apparent difference in male KOA with or without hypertension. As to the number of knee joints with OA, hypertension displayed no effect on whether single or both knees would be involved. Hypertension in KOA was significantly positively related to obesity. This was the case in both male and female group. Furthermore, hypertension in KOA was significantly positively related to osteoporosis and Ddimer concentration in blood plasma. However, after adjusted by gender, only female KOA showed statistically lower BMD and higher D-Dimer concentration as compared to simple KOA. Lastly, compared with simple KOA, hypertension KOA exhibited higher ESR, C-CRP, monocyte count and lower lymphocyte count, albeit being short of level of statistical significant. Conclusion:Hypertension may significantly relate to both occurrence and progression of KOA, especially to female’s KOA. Hypertension prevention may be useful in reducing future KOA risk.