Cardiovascular Disease Prevention Counseling Program for Systemic Lupus Erythematosus Patients

Abstract

Objective To determine if a cardiovascular disease prevention (CVD) counseling program for lupus patients decreases the prevalence of CVD risk factors. Methods The assessment phase of three-year CVD prevention counseling program included the evaluation of CVD risk factors, diet, exercise habits, and medications. The education phase included discussion of the above risk factors as well as CVD and thrombosis prevention strategies. Patients were prospectively followed every 3–6 months for risk assessment and continued education by a nurse practitioner and a medical doctor. Results Between March 2009 and December 2014, 121 patients were included. At baseline, abnormal blood pressure, blood glucose, cholesterol profile, and body mass index were found in 50 (41%), 7 (6%), 82 (68%), and 77 (64%) of patients, respectively. During the three-year follow-up, among those with abnormal baseline values: a) prevalence of abnormal blood pressure significantly decreased (OR: 0.94, 95% CI: 0.92–0.96, p<0.0001) with significant mean systolic blood pressure improvement (−6.12 ± 2.16 mmHg, p<0.05); b) prevalence of abnormal cholesterol profile significantly decreased (OR: 0.90; 95% CI: 0.92–0.96) with significant improvements in mean high-density lipoprotein (+5.4 ± 0.36 mg/dl, p<0.0001) and mean triglyceride levels (−12.6 ± 0.81 mg/dl, p<0.05); and c) no significant change in blood glucose and body mass index were observed. At baseline, 100 (83%) and 95 (79%) patients had poor diet and physical activity; during the follow-up, both significantly improved in the entire population. Conclusion Our data suggest that a CVD prevention counseling program decreases the prevalence of some CVD risk factors in lupus patients.

Genetic Background of Hypertension in Connective Tissue Diseases

“…But in our study, patients with CTD were characterized by higher water content, serum glucose, and triglyceride level when compared to healthy subjects. Changes in body compartments and metabolic parameters can be associated with an inflammatory state present in the course of autoimmune disorders as well as being a side effect of glucocorticosteroid use [32,33].…”

Non-pharmacological rehabilitation interventions for individuals with antiphospholipid syndrome: A scoping review

“…Yelnik and colleagues examined a cardiovascular disease prevention counseling program for 121 adults with lupus, including 15 who also had APS (i.e., secondary APS). 54 Tailoring this educational program for APS-specific considerations, such as using prompts or reminders to overcome cognitive deficits, may yield more significant results, as the researchers found no change to most cardiovascular risk outcome measures and poor follow-up over the 3-year period. To alleviate negative mental health concerns about feeling unsupported, unknown by the healthcare system and providers, or feeling socially isolated due to having a rare disease, examining a social media-based education intervention may be worthwhile.…”

Untitled

“…Lesions of the cardiovascular system in the case of SLE can manifest itself in the form of pericarditis, myocarditis, endocarditis, lesions of the heart valves, coronary arteries, aorta, conduction system, pulmonary hypertension occurrence [48,54,100,149,151,164].…”