Arterial stiffness and peripheral arterial disease in patients with systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is associated with increased cardiovascular risk. We aimed to evaluate arterial stiffness and the ankle brachial index (ABI), two markers of subclinical cardiovascular disease, in SLE. We studied 55 patients with SLE (12.7% males, age 53.3 ± 15.3 years) and 61 age- and gender-matched controls. Arterial stiffness was evaluated by measuring pulse wave velocity (PWV), augmentation index (AIx) and central systolic, diastolic, pulse and mean blood pressure (BP). Peripheral arterial disease was defined as ABI ≤ 0.90. Regarding markers of arterial stiffness, patients with SLE had lower PWV and AIx than controls (p < 0.01 and p < 0.05, respectively). However, after adjusting for differences in cardiovascular risk factors between patients with SLE and controls, PWV and AIx did not differ between the two groups. Central systolic, diastolic, pulse and mean BP also did not differ between the two groups. In patients with SLE, PWV correlated independently with systolic BP (B = 0.05, p < 0.001) and waist/hip ratio (B = 6.72, p < 0.05). Regarding ABI, the lowest ABI was lower in patients with SLE than in controls (p < 0.005). However, after adjusting for differences in cardiovascular risk factors between patients with SLE and controls, the lowest ABI did not differ between the two groups. The prevalence of PAD also did not differ between patients with SLE and controls (10.0 and 5.4%, respectively; p = NS). Markers of arterial stiffness and the ABI do not appear to differ between patients with SLE and age- and gender-matched controls. However, given the small sample size, larger studies are needed to clarify whether SLE promotes arterial stiffness and PAD.

Patients With Systemic Lupus Erythematosus Show an Increased Arterial Stiffness That is Predicted by IgM Anti–β2‐Glycoprotein I and Small Dense High‐Density Lipoprotein Particles

“…We did not identify an association between systemic inflammatory markers such as the erythrocyte sedimentation rate and the CRP level, as has been published previously (20,24,42,43). This finding could be related to the selection of the SLE patients for this study.…”

“…Several indices have been developed to assess arterial stiffness, including aortic pulse wave velocity (PWV) and the augmentation index (AIx) (17). It has been demonstrated in several studies that SLE patients show impaired arterial stiffness as measured by the AIx, which has been associated with inflammatory factors and SLE disease activity and duration (20)(21)(22)(23)(24)(25)(26). The AIx is associated with several cardiovascular risk factors, including age, hypertension, diabetes mellitus, hyperhomocysteinemia, and cigarette smoking.…”

“…In the Framingham Heart Study cohort, arterial stiffness was shown to be associated with an increased risk of developing a first cardiovascular event, thus improving prediction of classic risk factors (18,19). It has been demonstrated in several studies that SLE patients show impaired arterial stiffness as measured by the AIx, which has been associated with inflammatory factors and SLE disease activity and duration (20)(21)(22)(23)(24)(25)(26).…”

Subclinical parameters of arterial stiffness and arteriosclerosis correlate with QRISK3 in systemic lupus erythematosus

“…In one study that included 55 SLE and 61 CS matched by age, gender and BMI were evaluated by cfPWV. The cfPWV was increased in CS group but not in SLE patients even though the clinical characteristics of these patients [7]. In addition, there are several SLE reports trying to evaluate different cardiological findings with increased cfPWV [17], such as QT interval length [18], mean blood pressure [19], nocturnal arterial hypertension [20].…”

“…Methods for subclinical atherosclerosis using noninvasive tools are able to detect altered function and/or anatomy of vessels [2, 7]. Measurement of carotid intima-media thickness (cIMT) is well recognized as a good predictor of cardiovascular risk (CVR) in various diseases including rheumatoid arthritis (RA).…”