Methotrexate, a widely used medication for rheumatoid arthritis (RA), has been found to offer a significant secondary benefit: lowering blood pressure and potentially reducing the risk of heart disease in affected individuals. This discovery emerges from a new study conducted by researchers at Flinders University and the Southern Adelaide Local Health Network (SALHN), marking the first clear evidence of this effect in newly diagnosed RA patients.
The study, which compared methotrexate to another arthritis medication, sulfasalazine, involved 62 newly diagnosed adults who had not yet commenced treatment. Over a six-month period, the researchers monitored the participants’ blood pressure, joint inflammation, and arterial stiffness. The results revealed that methotrexate significantly lowered systolic blood pressure, offering a promising new avenue for heart health in RA patients.
Understanding Rheumatoid Arthritis and Its Implications
Rheumatoid arthritis is a prevalent autoimmune disease, affecting approximately one in 100 people. It causes inflammation and pain in the connective tissues of the joints, leading to significant discomfort and disability. The management of RA typically focuses on alleviating these symptoms, but the condition also poses increased risks for cardiovascular diseases.
Professor Arduino Mangoni, the lead author of the study and a Strategic Professor of Clinical Pharmacology at Flinders University, explains the significance of the findings. “We found that methotrexate lowered systolic blood pressure by an average of 7.4 mmHg compared with people taking sulfasalazine,” he states.
“This kind of reduction is considered meaningful because even a small drop in blood pressure can lower the risk of serious heart problems like heart attacks and strokes.” — Professor Arduino Mangoni
The Study’s Methodology and Findings
The researchers divided the participants into two groups: one receiving methotrexate and the other sulfasalazine. Blood pressure measurements were taken at the start, after one month, and at the end of the six-month period. The study’s results were compelling, showing that methotrexate not only managed RA symptoms but also contributed to cardiovascular health.
Interestingly, the blood pressure reduction did not correlate with changes in arthritis symptoms or arterial stiffness, suggesting alternative mechanisms at play. Professor Mangoni speculates that methotrexate may improve heart health by reducing inflammation or enhancing blood vessel function.
“We’ve known for a while that methotrexate helps with inflammation, but now we’re seeing that it may also help lower blood pressure, which is a major risk factor for heart disease,” he adds. “This could be a big step forward in how we care for people with rheumatoid arthritis.”
Genetic Factors and Personalized Medicine
The study also explored the role of genetics in methotrexate’s effectiveness. Certain genetic traits appeared to enhance the drug’s ability to lower blood pressure, opening the door to more personalized treatment strategies. Genetic testing could potentially identify patients who would benefit most from methotrexate’s cardiovascular advantages.
“In short, if someone has specific gene variants, methotrexate might add a heart health benefit to its usual role in treating rheumatoid arthritis by the positive effect on blood pressure.” — Professor Arduino Mangoni
Dr. Sara Tommasi, a study coordinator and medical scientist, emphasizes the need for further research to confirm these findings and elucidate methotrexate’s mechanisms in lowering blood pressure. “The results suggest that this well-known arthritis drug could also play a role in protecting heart health, especially in people who are at higher risk due to inflammation,” she notes.
Implications for Future Research and Treatment
This study, published in the Annals of Medicine, represents a significant advancement in understanding the multifaceted benefits of methotrexate. As researchers continue to explore the drug’s potential, the findings could lead to more comprehensive treatment plans for RA patients, integrating cardiovascular health considerations.
While methotrexate’s primary role remains the management of rheumatoid arthritis, its newfound benefits could transform patient care, particularly for those with heightened cardiovascular risk. The research team, including contributors from the University of South Australia and the University of Sassari in Italy, plans to pursue further studies to validate and expand upon these promising results.
The discovery of methotrexate’s impact on blood pressure underscores the importance of re-evaluating existing medications for additional health benefits, potentially improving outcomes for millions of patients worldwide.
