Methotrexate Cuts Systolic BP in Rheumatoid Arthritis

MONDAY, Sept. 15, 2025 (HealthDay News) — For patients with rheumatoid arthritis (RA), methotrexate significantly reduces systolic blood pressure (SBP), according to a study published online July 31 in the Annals of Medicine.

Arduino A. Mangoni, M.D., Ph.D., from Flinders University in Australia, and colleagues conducted a controlled comparative study of treatment-naive newly diagnosed RA patients commenced on subcutaneous methotrexate (group 1; 31 patients) or the disease-modifying antirheumatic drug comparator sulfasalazine (group 2; 31 patients). At baseline and after one and six months of treatment, clinic SBP and diastolic BP (DBP) and augmentation index were measured.

The researchers found that after six months, patients in group 1 had significantly lower SBP than those in group 2 (−7.4 mm Hg). No significant between-group differences were seen in DBP, augmentation index, or Disease Activity Score-28 C-reactive protein. During methotrexate treatment, there was a significant effect of single nucleotide polymorphisms rs1801133 (methyl tetrahydrofolate reductase) and rs2231142 (ATP-binding cassette subfamily G member 2) on BP changes.

“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,” Mangoni said in a statement.

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