title: [Screening and management of cardiovascular risk factors in systemic lupus erythematosus: Recommendations for clinical practice based on the literature and expert opinion].
abstract: OBJECTIVE
  To develop French recommendations about screening and management of cardiovascular risk factors in systemic lupus erythematosus (SLE).
  
  
  METHODS
  Thirty-nine experts qualified in internal medicine, rheumatology and nephrology have selected recommendations from a list developed based on evidence from the literature. For each recommendation, the level of evidence and the level of agreement among the experts were specified.
  
  
  RESULTS
  Experts recommended an annual screening of cardiovascular risk factors in SLE. Statins should be prescribed for primary prevention in SLE patients based on the level of LDL-cholesterol and the number of cardiovascular risk factors, considering SLE as an additional risk factor. For secondary prevention, experts have agreed on an LDL-cholesterol target of <0.7 g/L. Hypertension should be managed according to the 2013 European guidelines, using renin-angiotensin system blockers as first line agents in case of renal involvement. Aspirin can be prescribed in patients with high cardiovascular risk or with antiphospholipid antibodies.
  
  
  CONCLUSIONS
  These recommendations about the screening and management of cardiovascular risk factors in SLE can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of SLE patients.
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France. Electronic address: laurent.arnaud@psl.aphp.fr.
authors.forename: L
authors.initials: L
authors.lastname: Arnaud
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Mathian
authors.affiliation: Service de médecine interne et immunopathologie clinique, hôpital Purpan, Toulouse, France.
authors.forename: D
authors.initials: D
authors.lastname: Adoue
authors.affiliation: Service d'immunologie et rhumatologie pédiatrique, centre de référence des maladies rares rhumatologiques et inflammatoires pédiatriques (CERHUMIP), hôpital Necker, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Bader-Meunier
authors.affiliation: Service de néphrologie pédiatrique, hôpital Robert-Debré, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Baudouin
authors.affiliation: Service de médecine interne, CHU d'Angers, Angers, France.
authors.forename: C
authors.initials: C
authors.lastname: Belizna
authors.affiliation: Service de médecine interne et immunologie clinique, CHU Bocage, Dijon, France.
authors.forename: B
authors.initials: B
authors.lastname: Bonnotte
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Boumedine
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Chaib
authors.affiliation: Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Chauchard
authors.affiliation: Service de médecine interne, hôpital de la Conception, Marseille, France.
authors.forename: L
authors.initials: L
authors.lastname: Chiche
authors.affiliation: Service de néphrologie, hôpital Bichat, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Daugas
authors.affiliation: Service de médecine interne, CHU d'Angers, Angers, France.
authors.forename: A
authors.initials: A
authors.lastname: Ghali
authors.affiliation: Service de médecine interne et néphrologie, centre hospitalier d'Avignon, Avignon, France.
authors.forename: P
authors.initials: P
authors.lastname: Gobert
authors.affiliation: Service de médecine interne A, hôpital Dupuytren, CHU de Limoges, Limoges, France.
authors.forename: G
authors.initials: G
authors.lastname: Gondran
authors.affiliation: Service de médecine interne, hôpital Gabriel-Montpied, CHU, Clermont-Ferrand, France.
authors.forename: G
authors.initials: G
authors.lastname: Guettrot-Imbert
authors.affiliation: Service de médecine interne, hôpital Claude-Huriez, CHRU de Lille, Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: Service de médecine interne, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Hamidou
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Haroche
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Hervier
authors.affiliation: Service de néphrologie adulte, hôpital Necker, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Hummel
authors.affiliation: Service de néphrologie, hôpital de la Conception, Marseille, France.
authors.forename: N
authors.initials: N
authors.lastname: Jourde-Chiche
authors.affiliation: Service d'immunologie clinique, hôpital civil, CHU de Strasbourg, Strasbourg, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Korganow
authors.affiliation: Service de néphrologie pédiatrique, hôpital Robert-Debré, Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Kwon
authors.affiliation: Service de médecine interne, centre de référence maladies systémiques et auto-immunes rares, sclérodermies, vascularites, groupe hospitalier Cochin, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Le Guern
authors.affiliation: Service de médecine interne A, hôpital Saint-Éloi, Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Le Quellec
authors.affiliation: Service de médecine interne, CHU Henri-Mondor, Créteil, France.
authors.forename: N
authors.initials: N
authors.lastname: Limal
authors.affiliation: Service de médecine interne, CHU Jean-Minjoz, Besançon, France.
authors.forename: N
authors.initials: N
authors.lastname: Magy-Bertrand
authors.affiliation: Service de médecine interne, CHU de Reims, Reims, France.
authors.forename: P
authors.initials: P
authors.lastname: Marianetti-Guingel
authors.affiliation: Service d'immunologie clinique, hôpital civil, CHU de Strasbourg, Strasbourg, France.
authors.forename: T
authors.initials: T
authors.lastname: Martin
authors.affiliation: Service de médecine interne, CHU de Caen, Caen, France.
authors.forename: N
authors.initials: N
authors.lastname: Martin Silva
authors.affiliation: Service de rhumatologie, hôpital Bichat-Claude-Bernard, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Meyer
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Miyara
authors.affiliation: Service de médecine interne, hôpital Claude-Huriez, CHRU de Lille, Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Morell-Dubois
authors.affiliation: Service de médecine interne, hôpital Édouard-Herriot, CHRU de Lyon, Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Ninet
authors.affiliation: Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Papo
authors.affiliation: Service de médecine interne, CHU de Reims, Reims, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Pennaforte
authors.affiliation: Service de médecine interne 5D, CHU de Martinique, Fort-de-France, Martinique.
authors.forename: K
authors.initials: K
authors.lastname: Polomat
authors.affiliation: Service de néphrologie, hôpital Rangueil, CHU, Toulouse, France.
authors.forename: J
authors.initials: J
authors.lastname: Pourrat
authors.affiliation: Service de médecine interne, hôpital de l'Archet, Nice, France.
authors.forename: V
authors.initials: V
authors.lastname: Queyrel
authors.affiliation: Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, centre François-Magendie, Pessac, France.
authors.forename: I
authors.initials: I
authors.lastname: Raymond
authors.affiliation: Service de néphrologie, groupe hospitalier Henri-Mondor, Créteil, France.
authors.forename: P
authors.initials: P
authors.lastname: Remy
authors.affiliation: Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Sacre
authors.affiliation: Service de médecine interne, CHU Nord, Amiens, France.
authors.forename: J
authors.initials: J
authors.lastname: Schmidt
authors.affiliation: Service de rhumatologie, CHU Hautepierre, Strasbourg, France.
authors.forename: J
authors.initials: J
authors.lastname: Sibilia
authors.affiliation: Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, centre François-Magendie, Pessac, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Viallard
authors.affiliation: Service de médecine interne, CHU de Reims, Reims, France.
authors.forename: A
authors.initials: A
authors.lastname: Viau Brabant
authors.affiliation: Inserm U 1116, service de médecine vasculaire, département de médecine interne, institut lorrain du cœur et des vaisseaux Louis-Mathieu, centre de compétence régional des maladies systémiques et auto-immunes rares, CHU de Nancy, université de Lorraine, Vandœuvre-lès-Nancy, France.
authors.forename: D
authors.initials: D
authors.lastname: Wahl
authors.affiliation: Service d'endocrinologie, métabolisme et prévention cardiovasculaire, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Bruckert
authors.affiliation: Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
authors.forename: Z
authors.initials: Z
authors.lastname: Amoura
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008403:Mass Screening / Q000379:methods*; D012307:Risk Factors; D055502:Secondary Prevention
keywords: Cardiovascular risk factors; Dépistage; Guidelines; Lupus systémique; Prévention; Recommandations; Risque cardiovasculaire; Screening; Systemic lupus erythematosus