Written by Eileen Davidson, Arthritis Patient Advisory Board member
This article is for general information and educational purposes only. If you have questions or concerns about your blood pressure, medications, or cardiovascular health, connect with your healthcare provider.
When you live with arthritis, healthcare often focuses on pain, stiffness, fatigue, and medications —but your blood pressure matters too.
People living with inflammatory arthritis and other systemic autoimmune rheumatic diseases can have a higher risk of cardiovascular disease. That makes managing blood pressure and other cardiovascular risk factors an important part of overall arthritis care.
Dr. J. Antonio Aviña-Zubieta is a rheumatologist and senior scientist at Arthritis Research Canada. His current research focuses on the disease burden and cardiovascular complications associated with systemic autoimmune rheumatic diseases.
“People with arthritis face more than the symptoms affecting their joints,” says Dr. Aviña-Zubieta. “Cardiovascular health is a very important part of the bigger picture, and identifying and managing risk factors such as high blood pressure should be part of that conversation.”
What is Hypertension, and Why Does it Matter if You Have Arthritis?
Blood pressure measures the force of blood pushing against the wall of your arteries. The systolic number is the pressure when your heart beats, while the diastolic number is the pressure between heartbeats, when your heart relaxes.
According to the 2025 Hypertension Canada guidelines, hypertension in adults is defined as a blood pressure of 130/80 millimeters of mercury (mmHg) or higher when measured properly with a validated device. However, one high reading does not automatically mean you have hypertension, so home or ambulatory monitoring may be used to confirm it.
“People with arthritis have a higher frequency of traditional cardiovascular risk factors when compared to the general population, including high blood pressure, high cholesterol or diabetes,” explains Dr. Aviña-Zubieta.
“Early identification of these factors gives us a better understanding of a person’s overall cardiovascular risk,” he continues, “However, remember that even if you don’t have these ‘traditional risk factors’, patients with systemic autoimmune rheumatic diseases still have a higher risk of cardiovascular disease, especially if the inflammation is not controlled.”
How Can Arthritis Medications Affect Blood Pressure?
Some medications used to manage arthritis can affect blood pressure and cardiovascular health. This does not mean that these medications are unsafe or that you should stop taking them. Instead, it is important to understand their potential effects, monitor your blood pressure, and discuss this with your healthcare team.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, diclofenac, and celecoxib, are commonly used to manage arthritis pain and inflammation, but they can increase blood pressure and affect cardiovascular and kidney health.
Corticosteroids such as prednisone and methylprednisolone can also affect blood pressure. They may cause salt and fluid retention, particularly at higher doses or with long-term use. If your blood pressure increases after starting or increasing prednisone, let your healthcare provider know. Never stop long-term corticosteroids suddenly without medical guidance.
Arthritis medications are not the only drugs that can affect blood pressure. Decongestants, some antidepressants, stimulants, oral contraceptives, certain immunosuppressants, and dietary supplements may also raise blood pressure.
Make sure your healthcare provider knows about all the medications and supplements you take. This information can help them weigh the potential benefits and risks of your treatment.
Taking arthritis medications—such as hydroxychloroquine or methotrexate—as prescribed may help reduce the need for NSAIDs or corticosteroids. By controlling inflammation, some arthritis medications may also lower the risk of cardiovascular disease.
How to Talk to Your Doctor About Arthritis and Hypertension
Blood pressure should not be overlooked, even if your appointments are focused on arthritis. Your primary-care provider will usually manage hypertension, but your rheumatologist should also know because arthritis medications and cardiovascular risk can affect treatment decisions.
Bring your home blood-pressure readings and a complete medication list. Questions you may want to ask include:
1. Are my home readings high enough to be considered hypertension?
2. Could my NSAIDs, prednisone or other medications be raising my blood pressure?
3. What blood-pressure target is right for me?
4. Should we check my kidney function, cholesterol or blood sugar?
5. How does my inflammatory arthritis affect my cardiovascular risk?
6. Are my blood-pressure medications compatible with my arthritis medications?
7. How often should I check my blood pressure at home?
8. If my blood pressure stays high, should we investigate causes such as kidney disease or sleep apnea?
9. How can my family doctor and rheumatologist coordinate my care?
Taking Care of Your Cardiovascular Health
If you have inflammatory arthritis, managing your cardiovascular health is an important part of managing your overall health.
Management of hypertension may include reducing sodium (salty foods), eating a balanced diet, staying physically active within your abilities, limiting alcohol, avoiding smoking, improving sleep, and taking prescribed medication consistently. All of these activities are also beneficial to your arthritis and overall health.
Chronic disease care can easily become siloed, with different providers managing different parts of your health. That makes coordinated care especially important.
“Patients should not feel that they have to manage all of these risks on their own,” says Dr. Aviña-Zubieta. “Having an open conversation with your healthcare team about your arthritis, your medications and your cardiovascular health is an important place to start.”
Arthritis is already a whole-body health issue, and cardiovascular health needs to be part of the conversation.
