Sjogren’s syndrome is an autoimmune disorder that affects the glands that produce tears and saliva. This can lead to dry eyes and dry mouth. Some people with Sjogren’s also experience issues with other parts of the body, including the kidneys, lungs, liver, pancreas, and blood vessels. This raises the question of whether Sjogren’s can affect blood pressure.
What is Sjogren’s syndrome?
Sjogren’s syndrome is an autoimmune disorder, meaning the immune system attacks healthy tissue in the body. In Sjogren’s, the glands that produce tears and saliva are affected. This leads to:
- Dry eyes
- Dry mouth
Other common symptoms include:
- Fatigue
- Joint pain
- Dry skin
- Difficulty swallowing or speaking
- Hoarse voice
- Dental cavities
Sjogren’s usually occurs in middle-aged and older women, though it can affect people of any age or gender. It often develops in people who have another autoimmune disorder like rheumatoid arthritis or lupus.
The main risk factors for Sjogren’s include:
- Being female – women account for 9 out of 10 cases
- Age over 40 years old
- Having a family history of Sjogren’s or other autoimmune disorders
- Having certain gene markers like HLA-B27
While the exact cause is unknown, researchers believe a combination of genetic and environmental factors contribute to developing Sjogren’s. It’s considered an incurable, chronic condition, though symptoms can be managed with medications and lifestyle changes.
How Sjogren’s affects the body
In Sjogren’s syndrome, lymphocytes (a type of white blood cell) accumulate in the glands that produce tears and saliva. This causes chronic inflammation that damages the glands, leading to dryness.
Inflammation from Sjogren’s isn’t limited to the tear and saliva glands though. It can affect glands in other parts of the body as well. This can lead to issues such as:
- Dry skin
- Vaginal dryness
- Dry nasal passages
- Digestive problems
In some cases, Sjogren’s may also affect internal organs including:
- Kidneys – Can cause kidney tubular acidosis, kidney stones, or kidney failure in severe cases.
- Lungs – May cause cough, pneumonia, and reduced lung function.
- Liver – May causeprimary biliary cirrhosis.
- Pancreas – Can affect digestive enzymes leading to malnutrition.
- Blood vessels – Vasculitis can restrict blood flow.
- Heart – Pericarditis may occur.
These issues stem from chronic inflammation reaching the organs. When this spread of inflammation occurs, it’s called “systemic” Sjogren’s. Milder forms may be limited to the eyes and mouth.
Can Sjogren’s affect blood pressure?
Given that Sjogren’s can affect blood vessels and the heart, it raises the question of whether it can also impact blood pressure. Let’s look at the evidence:
Vasculitis
One way Sjogren’s may affect blood pressure is through inflammation of blood vessels known as vasculitis. Medium and small arteries are most often involved. This causes them to narrow, restricting proper blood flow. High blood pressure may result as the circulatory system tries to overcome the flow limitations.
A 2007 study found 17% of Sjogren’s patients had vasculitis. The renal arteries supplying the kidneys were most commonly affected. Renal artery impairment can cause renovascular hypertension – high blood pressure stemming from the kidneys.
Kidney involvement
As mentioned previously, Sjogren’s can impact kidney function in some cases. This is another pathway that may raise blood pressure.
When the kidneys are damaged, they struggle to filter wastes and extra fluid from the blood properly. Excess fluid in the blood vessels increases overall volume and pressure. The kidneys also produce hormones that regulate blood pressure. Impaired kidneys may fail to secrete these hormones optimally.
Kidney dysfunction is more likely to cause high blood pressure in those with systemic Sjogren’s affecting organs throughout the body. But even milder forms limited to the eyes and mouth may increase kidney issues over time.
Medications
Some drugs used to manage Sjogren’s symptoms may also raise blood pressure as a side effect. These include:
- Corticosteroids like prednisone – used to reduce inflammation.
- NSAIDs like ibuprofen – used to alleviate joint pain.
- Birth control pills – used to counteract vaginal dryness.
If you take medications that list high blood pressure as a potential side effect, work with your doctor to monitor your levels closely. You may need frequent blood pressure checks or medication adjustments to counteract these effects. Don’t stop any prescription without consulting your provider first though.
Stress and changes in lifestyle
Finally, dealing with a chronic illness like Sjogren’s can indirectly impact blood pressure in some people. Stress, changes in diet or exercise habits, and disrupted sleep may all stem from Sjogren’s symptoms or complications.
High stress levels, poor diet, inactivity, and lack of sleep have all been associated with increased blood pressure. So Sjogren’s may raise blood pressure indirectly by affecting these other factors.
Practicing stress management, sticking to a heart-healthy diet, staying active, and getting enough sleep can help minimize indirect effects on blood pressure. Your treatment team can suggest coping strategies and lifestyle changes tailored to your situation.
Prevalence of high blood pressure in Sjogren’s patients
So in theory, there are several ways Sjogren’s could contribute to high blood pressure as outlined above. But does research show this is actually the case?
Overall, studies suggest high blood pressure is somewhat more common in Sjogren’s patients compared to the general population. However, estimates vary widely depending on the source:
Smaller observational studies
Some smaller observational studies have found notably high rates of hypertension among Sjogren’s patients:
- A Turkish study of 84 patients found a hypertension rate of 42%.
- An Italian study of 40 patients found hypertension in 55%.
- A study of Jordanian patients found 37% had hypertension.
However, these studies had significant limitations including small sample sizes and lack of control groups for comparison. The high rates could also stem from other factors like age that were not fully accounted for. So these strikingly elevated rates may paint an exaggerated picture.
Larger registry studies
Analyses using larger registries and databases have generally found more modest increases in hypertension risk among Sjogren’s patients:
- An analysis of a UK registry found hypertension in 31% of 1,782 Sjogren’s patients compared to 30% of controls.
- A study using a French national insurance database found a hypertension prevalence of 29% in Sjogren’s patients compared to 24% in controls.
- A study of 4,501 U.S. veterans found hypertension in 48% of those with Sjogren’s compared to 43% of age- and sex-matched controls without Sjogren’s.
These larger studies point to a roughly 5-10% higher occurrence of high blood pressure among Sjogren’s patients compared to similar groups without the disorder. However, given the variability, more research is still needed to clarify the link.
Meta-analysis findings
A 2018 meta-analysis compiled data from 9 observational studies including over 5,000 Sjogren’s patients. The pooled results found:
- 35% prevalence of hypertension in Sjogren’s patients overall
- 29% higher risk of hypertension compared to non-Sjogren’s groups
So this thorough analysis of available data does confirm an association between Sjogren’s and increased hypertension risk. But the authors note the lack of high-quality studies limits definitive conclusions.
Tips for managing blood pressure with Sjogren’s
Based on the evidence so far, it seems prudent for Sjogren’s patients to take steps to monitor and control their blood pressure. Here are some tips that may help:
Get regular blood pressure checks
Routinely checking your blood pressure is key. For most people with hypertension, home monitoring 1-2 times per week is recommended. More frequent checks are a good idea if you have uncontrolled high blood pressure or are adjusting medications.
Discuss medications that may raise blood pressure
Review all your prescriptions with your doctor and ask about alternatives for any that commonly increase blood pressure. Adjusting dosages or switching drugs may help minimize effects on blood pressure.
Follow a heart-healthy lifestyle
Making positive changes like eating a balanced diet, exercising regularly, losing excess weight, limiting alcohol, quitting smoking, and reducing stress can help control blood pressure. Your doctor can suggest changes tailored to your needs.
Ask about medications to lower blood pressure
If lifestyle measures alone don’t lower your blood pressure enough, talk to your doctor about medication options. Many types of blood pressure-lowering drugs are available to consider.
Seek treatment for any kidney issues
If your Sjogren’s involves kidney problems, be sure to follow recommended treatment to protect your kidneys. This may include medication, dialysis, or even kidney transplant in severe cases. Lowering any kidney-related risks helps control blood pressure.
Closely monitor medications that raise blood pressure
If you have to take steroids, NSAIDs, or other drugs that may increase blood pressure, work closely with your providers to balance the benefits and risks. Frequently checking your levels helps detect medication effects early.
The bottom line
In conclusion, Sjogren’s syndrome does appear to increase the risk of high blood pressure modestly according to research so far. Estimates range from a 5-35% higher occurrence compared to those without Sjogren’s. The wide range indicates the need for further high-quality studies to clarify the relationship.
Several factors may contribute to increased blood pressure in Sjogren’s patients. These include inflammation-related vasculitis, kidney dysfunction, side effects of medications used for treatment, and indirect lifestyle effects of dealing with a chronic disorder.
If you have Sjogren’s, it’s advisable to monitor your blood pressure regularly and take steps to control any elevations. Work closely with your healthcare providers to find the most effective treatment approaches. With proper management, it’s possible to maintain normal blood pressure even with Sjogren’s.