Ankylosing Spondylitis Increases Risk of Depression, Hypertension: Study

Ankylosing spondylitis (AS) is a form of arthritis that affects the spine. The condition has previously been associated with serious comorbidities. In fact, it has been found in a new study that patients with the condition are much more likely to suffer from these other medical problems than people of the same sex and age, but without ankylosing spondylitis. The conditions with the highest rates of comorbidity with ankylosing spondylitis are hypertension, depression, and dyslipidemia.

Data for the study was collected from the MarketScan Commercial Claims and Encounters and Medicare Supplemental databases. The researchers compared the medical records of patients with ankylosing spondylitis to those of control participants of the same sex and age as the ankylosing spondylitis patients. Controls matched patients’ age, geographic region, index calendar year, and sex. In total, the researchers analyzed the records of 6,679 ankylosing spondylitis patients and 19,951 controls.

“On this real-world, U.S. claims-based study, patients with ankylosing spondylitis were shown to have significantly more comorbidities than matched controls,” the researchers write in the published study.

The researchers noticed a significant increase in the incidence of certain comorbidities in the ankylosing spondylitis patients when compared to the controls. The comorbidities the ankylosing spondylitis patients showed the highest inclination toward developing included asthma, cardiovascular diseases, depression, dyslipidemia, gastrointestinal ulcers, malignancies, multiple sclerosis, osteoporosis, sleep apnea, spinal fracture, inflammatory bowel disease, psoriasis, and uveitis (inflammation in the uvea, the middle layer of the eye).

AS Associated with Increased Risk of Comorbidities

The ankylosing spondylitis patients were 26 times more likely to develop uveitis as the controls and eight times more likely to also suffer from irritable bowel disease. Multiple sclerosis, osteoporosis, and spinal fracture were considered three or four times more likely to be seen in the AS patients in comparison to the controls.

Asthma, depression, gastrointestinal ulcers, sleep apnea, and venous thromboembolism were twice as common in the ankylosing spondylitis patients. There were no differences between the AS participants and the controls in regard to increased risk of peripheral vascular disease, diabetes, and Parkinson disease.

“This study did not examine the causality of the association between AS and comorbidities. A potential explanation is that patients have shared genetic or environmental risk factors that predispose them to both AS and to the comorbidities. Other possibilities are that AS may increase the risk of the evaluated comorbidities or that AS may be a marker for or consequence of unidentified risk factors that contribute to the risk of both AS and the comorbidities,” the authors of the study wrote.

There were also noted differences between the male and female patients in the study. The female participants with ankylosing spondylitis showed an increased incidence of asthma, depression, and osteoporosis. The male ankylosing spondylitis patients were more likely to suffer from cardiovascular disease, dyslipidemia, hypertension, malignancies, sleep apnea, and spinal fracture.

This study provides a correlational basis for the belief that ankylosing spondylitis patients are at a higher risk level of developing the comorbidities discussed here, compared to people without the condition. Future studies will be required in order to establish a causational understanding of the relationship.

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