Prevalence of conventional and lupus‐specific risk factors for cardiovascular disease in patients with systemic lupus erythematosus: A case–control study

Bessant, Rupa; Duncan, Rachel; Ambler, Gareth; Swanton, Jo; Isenberg, David; Gordon, Caroline; Rahman, Anisur

doi:10.1002/art.22343

Cited by 96 publications

(83 citation statements)

References 23 publications

(27 reference statements)

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“…Studies invariably show a higher prevalence of systemic arterial hypertension in SLE patients compared to controls [8,9,17,21,22,30,31]. This may in part be explained by the use of corticosteroids and the presence of nephritis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age

2015

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Systemic lupus erythematosus (SLE), an autoimmune inflammatory disease, is associated with an increased prevalence of accelerated atherosclerosis and cardiovascular events. Metabolic syndrome (MetS) is a set of cardiovascular risk factors in SLE patients, which may lead to a proinflammatory condition and increased morbidity and mortality. The objective of this study was to evaluate the prevalence of MetS in a cohort of SLE patients versus healthy controls, and to analyze the association of clinical and demographic factors. SLE patients (n = 146) treated at a Northeast Brazilian university hospital were evaluated with regard to demographic, clinical, laboratory, and anthropometric parameters and compared to controls (n = 101). MetS was diagnosed according to the definition of 2005 NCEP/ATP III. The average age of SLE patients was 41.7 ± 12.5 years, and 91.8 % were female. MetS was significantly more prevalent in SLE patients (45.2 %) than in controls (32.7 %; p = 0.04). The MetS components such as hypertension, diabetes, and hypertriglyceridemia were significantly more prevalent in SLE. In the univariate analysis, MetS in SLE patients was associated with age, disease duration, Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index, smoking, menopause, nephritis, cyclophosphamide use, prednisone dose, and chloroquine use, which appeared to have a protective effect. In the logistic regression analysis, age, disease activity, nephritis, and smoking were statistically significant. The prevalence of MetS observed in our cohort of SLE patients from Northeastern Brazil is higher than controls. MetS components should be routinely investigated to minimize the occurrence of MetS and associated cardiovascular morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Prevalence of metabolic syndrome in a cohort of systemic lupus erythematosus patients from Northeastern Brazil: association with disease activity, nephritis, smoking, and age

2015

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“…As the antiinflammatory/immunosuppressive treatment of patients with SLE continues to improve [56], the contribution of CVD to morbidity and mortality is likely to increase [57].…”

Section: Lupus Treatmentmentioning

confidence: 99%

“…Hydroxychloroquine has several protective effect, including effects on the reducing serum lipid profile, increase HDL, reduces the insulin resistance and inhibition of platelet aggregation in SLE [57].…”

Section: Lupus Treatmentmentioning

confidence: 99%

Risk Factors in Cardiovascular Disease in Systemic Lupus Erythematosus

Sinicato¹,

Cardoso²,

Appenzeller

2013

CCR

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Systemic lupus erythematosus (SLE) is a chronic and multisystemic autoimmune disorder which predominantly affecting women. The most common cause of death in SLE patients affected by disease for more than 5 years is cardiovascular disease (CVD). Epidemiological observations suggest that, together with classical conventional risk factors, other mechanisms (non-conventional/disease-specific factors) promote accelerated atherosclerosis in inflammatory diseases like SLE. Traditional CVD risk factors included age, hypertension, diabetes mellitus, dyslipidemia, previous vascular event defined as previous history of cerebrovascular accidents or ischemic heart disease, menopause and smoking. The nontraditional factors presents in SLE are disease-specific like renal disease manifestation as Lupus nephritis (LN), presence of pro-inflammatory cytokines, some of inflammatory mediators, antiphospholipid antibodies, anti-oxLDL antibodies, corticosteroid uses and cumulative dose of glucocorticoids. We will review traditional and non-traditional risk factors associated with CVD in SLE patients.

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“…This finding emphasizes the need for corticosteroid monitoring and the use of steroid-sparing agents in the clinical care of SLE patients. (Thompson et al,2008) Patients with SLE and CVD were more likely than SLE age-matched controls (without CVD) to have taken a mean dosage of prednisone of over 7.5 mg/day (p = 0.04) and more likely to have been treated with pulse methylprednisolone (p = 0.03) (Bessant et al, 2006) A longer duration of corticosteroid use (11 vs 7 years; p = 0.002) was more common in the patients who had an event than in those without an event. (Manzi etal, 1997) Women with SLE who had a longer duration of prednisone use and higher cumulative dose of prednisone are more likely to have carotid plaque on ultrasound ( Manzi et al,1999) and the IMT progression is associated with years of steroid use.…”

Section: Corticosteroidsmentioning

confidence: 99%