Atheroma and systemic lupus erythematosus.
Epidemiologic data indicate a large increase in cardiovascular risk in patients with systemic lupus erythematosus (SLE). Non-invasive investigations show increases in intima-media thickness, carotid plaque, and coronary artery calcifications in patients with SLE, compared to controls. Conventional cardiovascular risk factors may fail to fully explain the high cardiovascular risk in SLE patients. Immunological disturbances and inflammation may indirectly contribute to the risk of cardiovascular disease by inducing dyslipidemia and/or insulin resistance. The potential role for glucocorticoid therapy is controversial. Effective control of the disease would be expected to decrease the cardiovascular morbidity and mortality rates. Careful attention should be given to controlling conventional risk factors such as obesity, smoking, and physical inactivity. Hypertension and/or dyslipidemia should be treated optimally. The appropriateness of antiplatelet therapy should be assessed.
Soubrier
Martin
M
G. Montpied Hospital, Service de Rhumatologie, Place Henri Dunant, BP 69, 63003 Clermont-Ferrand, France. msoubrier@chu-clermontferrand.fr
Mathieu
Sylvain
S
Dubost
Jean-Jacques
JJ
D000962:Antimalarials / Q000009:adverse effects; D050197:Atherosclerosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D002114:Calcinosis / Q000209:etiology / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology; D003324:Coronary Artery Disease / Q000209:etiology / Q000473:pathology; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology
D000962:Antimalarials; D005938:Glucocorticoids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors