Methotrexate blood pressure and cholesterol?

[marie66]

Ok been on methotrexate 15months still have some GI problems but coping! Trouble is my BP is up and my cholesterol too! Looking a4 meds for both! Anyone else experienced this...is it the drug or just par for the RA course? M x

[janmary]

As far as I know raised B/P can go with RA because the inflammatory response can affect blood vessels.

Mine went up when I'd been on M/X for a year or two, but I think it was because of NSAID's (naproxen, ibuprofen etc), which are known to raise B/P. It's come down since I stopped taking them - don't think they helped much anyway!

[Simba1992]

You could try Colostrum powder, natural way to calm your stomach, doesn't interfere with mtx that is really hard on the gut. You can get it from amazon, just one spoonful mixed with water on an empty stomach in the morning😊

xxSimba

[helixhelix]

They are both very common things, so could just be coincidence. Equally some drugs like Leflunomide and anti-inflammatories can raise BP, and lifestyle issues too.

Because RA does increase risk of cardiovascular problems like heart attacks and strokes, when I was first diagnosed I made a big effort with diet and exercise, and both BP and cholesterol improved. However even tho' my cholesterol was within normal range (5) my rheumy wanted it to be below 4 so I now take statins. Then suddenly at Xmas after 6 years on the drugs my BP rocketed up, possibly as a result of a heart valve problem I've developed although the doctors just shrug and say it's one of those things that happens with age.

So I've had to start taking BP meds too. So another lot of pills to take every day. However don't seem to have caused any side effects, and had the right result as BP and cholesterol both now fine. They go ok with all my other meds.

However I'm still trying to make more lifestyle improvements to see if I can get off the BP drugs at least.

[Simba1992]

High blood pressure evidently not a common side effect.

treato.com/Methotrexate,Hig...

[helixhelix in reply to Simba1992]

Do be careful about "conclusions" drawn from the treato site. It is merely self-reporting from self-selected patients,so no way of knowing whether it is even vaguely accurate, representative etc etc.

[Simba1992]

Here something on mtx and cholesterol

the-rheumatologist.org/arti...

[marie66]

Thanks guys. Just a thought could it be the steroids to blame? Been on pred. for two years trying to get control? Didn't have any bp or cholesterol issues before now. My diet is fine, I'm vegetarian don't smoke or drink and don't do caffeine or dairy! M x

[Simba1992]

There is a lot of recent reaserch on the effect of lectin on cardiovascular health. It's not a bad idea to try to protect your body when taking RA meds. Dietary modifications that have shown to have an effect on CV health could perhaps help.

brendawatson.com/lectin-res...

[Jacey15]

My cholesterol went up from 4.77 mmol/L to 6.30 mmol/L following treatment with methotrexate and there are a couple of peer reviewed journal publications of studies done in the US where a proportion of patients on mtx had a subsequent rise in cholesterol. Because they are US studies the units are different to the UK but I managed to find the conversion factor and the average increase was 1.45 mmol/L. I'm assuming that is why it gets tested for on my annual review.

[Simba1992 in reply to Jacey15]

Sorry that was the wrong one, couldn't find the right one but here is something of Dr. Grundy.

gundrymd.com/food-pyramid/

[Jacey15 in reply to Jacey15]

1. Arthritis Rheum. 2013 Jun;65(6):1430-8. doi: 10.1002/art.37916.

Changes in lipoproteins associated with methotrexate or combination therapy in early rheumatoid arthritis: results from the treatment of early rheumatoid arthritis trial.

Navarro-Millán I(1), Charles-Schoeman C, Yang S, Bathon JM, Bridges SL Jr, Chen L, Cofield SS, Dell'Italia LJ, Moreland LW, O'Dell JR, Paulus HE, Curtis JR.

Author information:

(1)University of Alabama at Birmingham, Birmingham, AL 35294, USA.

OBJECTIVE: To study changes in lipid profiles at 24 weeks among patients with early rheumatoid arthritis (RA) participating in the Treatment of Early RA (TEAR) trial and randomized to receive methotrexate (MTX) plus etanercept, triple therapy (MTX plus sulfasalazine plus hydroxychloroquine), or aggressively titrated MTX monotherapy.

METHODS: This TEAR substudy included 459 participants with biologic specimens. Serum levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol were measured at 0 and 24 weeks.

RESULTS: At 24 weeks, there were statistically significant increases in mean cholesterol levels in the MTX plus etanercept, triple therapy, and MTX monotherapy arms. The observed increases were 31.4 mg/dl, 28.7 mg/dl, and 30 mg/dl in LDL cholesterol, 19.3 mg/dl, 22.3 mg/dl, and 20.6 mg/dl in HDL cholesterol, and 56.8 mg/dl, 53 mg/dl, and 57.3 mg/dl in total cholesterol (P <0.0001 versus baseline for each comparison). There was a statisticallysignificant decrease in the ratio of total cholesterol to HDL cholesterol at 24 weeks in all 3 treatment groups versus baseline. There was no difference in any lipid changes between the 3 treatment arms. After multivariable adjustment,change in C-reactive protein, but not the Disease Activity Score in 28 joints, was associated with change in LDL cholesterol (P = 0.03) and total cholesterol (P= 0.01). Baseline glucocorticoid use was associated with changes in HDL cholesterol (P = 0.03) and total cholesterol (P = 0.02).

CONCLUSION: Levels of total cholesterol, LDL cholesterol, and HDL cholesterol increased comparably shortly after initiation of MTX plus etanercept, triple therapy, and MTX monotherapy among patients with early RA with active disease participating in a clinical trial. The clinical relevance of short-term changes in traditional lipids on cardiovascular outcomes remains to be determined.

Copyright © 2013 by the American College of Rheumatology

[Simba1992]

Interesting interview with Dr. Gundry on lectins.

vimeo.com/202800007

[marie66]

Update. ..eventually got a consultation with gp. On the cholesterol issue, its borderline he says number means little? I don't have markers that cause worry as no smoking, alcohol, caffeine etc. He's happy to leave that for now but the BP was different the numbers average out at 140/91 and Leflunomide will raise it a few points so I'm starting Ramipril 2.5mg daily. M x

[Jacey15 in reply to marie66]

Sounds good xXx

[marie66]

Thanks everyone for input. ((hugs)) M x