Methotrexate, a widely used medication for treating rheumatoid arthritis, has been found to offer an unexpected benefit: lowering blood pressure and potentially reducing the risk of heart disease in patients. This revelation comes from a recent study led by researchers at Flinders University and Southern Adelaide Local Health Network (SALHN).
The study provides the first clear evidence that methotrexate significantly lowers blood pressure compared to sulfasalazine, another arthritis medication. This finding is particularly significant for newly diagnosed patients with rheumatoid arthritis, a common autoimmune disease affecting about one in 100 people, causing inflammation and pain in the joints.
Study Details and Findings
Over a six-month period, researchers from South Australia and Italy monitored 62 newly diagnosed adults who had not yet begun treatment. Participants were divided into two groups: one received methotrexate, while the other was administered sulfasalazine. The study measured blood pressure, joint inflammation, and arterial stiffness at the outset, and then again after one and six months.
Professor Arduino Mangoni, the lead author from Flinders University’s College of Medicine and Public Health, explained the study’s aim to determine methotrexate’s effect on systolic blood pressure, which measures the pressure exerted by blood against artery walls during heartbeats.
“We found that methotrexate lowered systolic blood pressure by an average of 7.4 mmHg compared with people taking sulfasalazine,” stated Professor Mangoni. “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.”
Implications for Heart Health
Interestingly, the blood pressure reduction was not linked to improvements in arthritis symptoms or arterial stiffness, suggesting methotrexate might benefit the heart through other mechanisms, such as reducing inflammation or enhancing blood vessel function.
Professor Mangoni highlighted the broader implications of these findings, noting that methotrexate might offer more than just relief for rheumatoid arthritis symptoms. “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 said. “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. Researchers discovered that certain genetic traits made some individuals more likely to experience a drop in blood pressure while on the medication.
“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,” explained Professor Mangoni.
This discovery opens the door to personalized treatment options. Genetic testing could help doctors predict who might benefit most from methotrexate’s heart-protective effects, tailoring treatment plans to individual patients.
Future Research and Potential
Dr. Sara Tommasi, study coordinator and medical scientist, emphasized the need for further research to confirm these findings and fully understand how methotrexate lowers blood pressure. Nevertheless, the results are promising.
“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,” said Dr. Tommasi from the College of Medicine and Public Health and South Adelaide Local Health Network.
The research, titled ‘A controlled comparative study of the effects of methotrexate and pharmacogenetic factors on arterial blood pressure and arterial stiffness in patients with rheumatoid arthritis,’ was published in the Annals of Medicine journal. This study represents a significant step forward in understanding the multifaceted benefits of methotrexate, potentially paving the way for more comprehensive treatment strategies for rheumatoid arthritis patients.
