Morning Stiffness Correlates with Disease Activity, Blood Pressure and Cholesterol Levels in Patients with Seropositive Rheumatoid Arthritis
Nejra Mlaco-Vrazalic1, Alen Omanovic2, Amela Dinar-Mostic3, Sejla Ceric4,5, Amela Sofic6, Akif Mlaco5,7
1 Department of Internal Medicine, General Hospital “Prim. Dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina
2 Family Medicine Department, Health Care Center, Visoko, Bosnia and Herzegovina
3 Department of Neurology, Health Care Center, Visoko, Bosnia and Herzegovina
4 Department for Nuclear Medicine, Clinic for Endocrinology and Nuclear Medicine, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
5 Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
6 Department of Radiology, General Hospital “Prim. Dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina
7 Department of Angiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Corresponding Author: Dr Nejra Mlaco-Vrazalic MD. Department of Internal Medicine, General Hospital “Prim. dr Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina; E-mail: nejra.ml@gmail.com; Phone: +387 33 285 100; ORCID ID: https://orcid.org/0000-0002-3299-6899.
Cite this article: Mlaco-Vrazalic N, Omanovic A, Dinar-Mostic A, Ceric S, Sofic A, Mlaco A. Morning Stiffness Correlates with Disease Activity, Blood Pressure and Cholesterol Levels in Patients with Seropositive Rheumatoid Arthritis. Sar Med J. 2024; 1(2): Online ahead of print. 
10.70119/0017-24
Pages: 63-68 / Published online: 17 December 2024
Original submission: 19 August 2024; Revised submission: 16 November 2024; Accepted: 25 November 2024
Abstract
Introduction. Morning stiff ness (MS) is the hallmark of rheumatoid arthritis (RA) and it has important implications on daily life of the patients. There are confl icting reports of its association with disease activity.
Methods. This observational study included 125 patients with seropositive RA from Health Care Center, Visoko. We obtained data on patient’s gender and age, duration of RA, pain in hands and feet, MS and its duration, hospital admission, blood pressure, laboratory values and treatment modalities.
Results. MS lasted up to 30 minutes in 71 (56.8%) patients, 30 to 60 minutes in 40 (32%) patients, and more than 60 minutes in 14 (11.2%) patients. There was no diff erence in the du-ration of MS between genders. Patients with longer MS were younger and had a longer duration of illness. Patients with MS longer than 30 minutes had higher blood pressure and cholesterol le-vels. ESR in the second hour and CRP correlated with a duration of MS. Patients on methotrexate had a longer duration of MS. No signifi cant diff erences in the duration of MS were observed for lefl unomide, corticosteroids and supportive treatment modalities.
Conclusion. Duration of MS correlates with RA disease activity and remains an important bur-den for patients. Usage of newer treatment options, such as biologic disease-modifying antirhe-umatic drugs (DMARDs), may be required.
Keywords: COVID-19, Hypercoagulability, Thrombosis, Venous thromboembolism, Vitamin K epoxide reductase.
