Prevalence of hypertension in familial mediterranean fever patients and relationship of amyloidosis with blood pressure

Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent fever and serosal inflammation. FMF presents with inflammatory attacks and subclinical inflammation between the attacks. Secondary amyloidosis develops as a result of chronic inflammation is the most important long- term complication. There are studies in the literature showing the effect of inflammation on blood pressure control systems at cardiovascular, renal, neural, endocrine and tissue levels. In our study, it is aimed to determine the frequency of hypertension in FMF patients and to show the relationship between amyloidosis and blood pressure. In this retrospective data screening study, 603 patients who were admitted to Hacettepe University Hospitals Department of Internal Medicine Nephrology Outpatient Clinic with the diagnosis of Familial Mediterranean Fever were evaluated. Hypertension was observed in 102 of 603 FMF patients. The frequency of hypertension was found to be 16.9% in FMF patients. No significant difference was found between male and female sex in the frequency of hypertension. When the FMF patients and 1329 people in the control group were compared, the frequency of hypertension, systolic and diastolic blood pressure values were significantly lower in the FMF group (p = 0.028, p <0.001, p = 0.012). Comparing FMF patients and control group without the diagnosis of hypertension, systolic blood pressure values were significantly lower in FMF group (p <0.001). There was no significant relationship between homozygous and heterozygous M694V mutation and hypertension. When patients with and without amyloidosis were compared, patients with amyloidosis were found to have higher blood pressure (p <0.001). When the patients with GFR> 60 ml / min / 1.73m2 with and without amyloidosis were compared, no significant difference was observed between the two groups. When the patients with GFR> 60 ml / min / 1.73m2 with amyloidosis and control group were compared, systolic blood pressure values were significantly lower in the group with amyloidosis (p = 0.002). It was thought that the frequency of hypertension and low blood pressure values may be associated with the anti-inflammatory and cardioprotective effect of colchicine in FMF patients compared to the normal population. The fact that the frequency of coronary artery disease, heart failure and diabetes on the background of chronic inflammation was not different from the general population also supported our opinion. In addition to the fact that amyloidosis does not cause elevated blood pressure unless it decreases glomerular filtration rate, it was thought that it may cause low systolic blood pressure values with cardiovascular, autonomic nervous system and adrenal gland involvement. Keywords: Familial Mediterranean Fever, Hypertension, Amyloidosis, Chronic inflammation, Blood Pressure