Tumor necrosis factor alpha (TNF-) inhibitors are increasingly being used in inflammatory rheumatic diseases (IRD). The risk of cardiovascular disease is elevated in patients with IRD and TNF- inhibitors reduce this risk. We assessed whether the beneficial effect of TNF- inhibitors on cardiovascular risk is mediated by blood pressure reduction. We measured blood pressure levels with 24-h ambulatory blood pressure measurements device in patients with IRD before and 3 months after treatment with TNF- inhibitors. The study population consisted of 15 subjects (6 men; mean age 45.9 +/- 14.1 years). Most patients had either rheumatoid arthritis or psoriatic arthritis and adalimumab was the most common TNF- inhibitor used. Mean 24-h systolic and diastolic blood pressure levels remained the same after treatment (121 +/- 12/66 +/- 7 before and 123 +/- 11/67 +/- 10mm Hg after; p=0.88 and 0.66, respectively). The study demonstrates that TNF- inhibitors have no effect on blood pressure levels.