Résumé
Patients with autoimmune diseases have an increased risk of cardiovascular morbidity and mortality, mostly related to cardiovascular risk factors, such as hypertension, and systemic inflammation. Methods: MEDLINE and EMBASE libraries were systematically searched for controlled studies of hypertension and cardiovascular complications in patients with either systemic lupus erythematosus (SLE), or rheumatoid arthritis (RA), or psoriasis including psoriatic arthritis (PsA), or Sjogren’s syndrome (SS), or ANCA-associated vasculitis (AAV), between January 2000 and March 2022. We extracted, in all appropriate studies, the prevalence of hypertension and cardiovascular complications, as well as study and participants characteristics, to perform random-effects meta-analyses. A multivariate meta-regression was performed to explore factors related to hypertension prevalence.Results: of the 2,726 references screened, 122 studies were included in the meta-analysis. The prevalence of hypertension was higher in patients with an auto-immune disease compared to healthy controls, with an overall unadjusted OR of 1.67 [1.58-1.76] and an adjusted OR of 1.36 [1.24-1.50]. All diseases appeared to be associated with an increased risk for hypertension (SLE adjusted OR 3.40 [1.93-6.00]; psoriasis 1.32 [1.16-1.51]; PsA 1.49 [1.15-1.94]; RA 1.28 [1.04-1.58]; SS 2.02 [1.19-3.44]). Age and female sex were significantly associated to the OR of hypertension in AD patients compared to controls. The risk of cardiovascular complications was also increased (ischemic heart disease adjusted OR 1.38 [1.21-1.57]; cerebrovascular disease 1.37 [1.03-1.81]; heart failure 1.28 [1.05-1.55]; peripheral arterial occlusive disease 1.73 [1.30-2.32], plaques 2.46 [1.84-3.29]).Conclusion: the prevalence of hypertension is increased in autoimmune diseases. Its screening and management are of paramount importance to reduce the risk of cardiovascular complications in these patients.