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Risk factors for coronary heart disease in women with systemic lupus erythematosus: the Toronto Risk Factor Study

Ian N Bruce1, Murray B Urowitz, Dafna D Gladman

  • 1University of Toronto Lupus Clinic, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada.

Arthritis and Rheumatism
|November 13, 2003
PubMed

Insights

Women with systemic lupus erythematosus (SLE) have more coronary heart disease (CHD) risk factors, but the Framingham formula doesn't fully capture this risk. Further research is needed to understand SLE's impact on heart health.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Epidemiology

Background:

  • Women with systemic lupus erythematosus (SLE) face a 5-8 times higher risk of coronary heart disease (CHD) compared to the general population.
  • Understanding the prevalence of classic CHD risk factors in SLE patients is crucial for risk stratification and management.

Purpose of the Study:

  • To assess the prevalence of classic coronary heart disease (CHD) risk factors in women with systemic lupus erythematosus (SLE).
  • To compare CHD risk factors and 10-year CHD event risk between SLE patients and a control group.

Main Methods:

  • A cohort of 250 female SLE patients without evidence of CHD was compared to 250 age-matched controls.
  • The Framingham risk assessment formula was used to determine 10-year CHD risk.
  • Lipid subfractions, metabolic factors, lifestyle, and demographics were analyzed.

Main Results:

  • SLE patients exhibited higher prevalence of hypertension and diabetes.
  • Despite a higher mean number of risk factors per patient, the 10-year CHD risk was similar between groups (3.2%) using the Framingham formula.
  • SLE patients had elevated very low-density lipoprotein cholesterol, triglycerides, and homocysteine, alongside higher rates of premature menopause and sedentary lifestyles.

Conclusions:

  • Women with SLE possess numerous CHD risk factors not adequately captured by the Framingham risk formula.
  • These unmeasured factors likely explain the increased CHD susceptibility observed in SLE patients.
  • Further investigation is warranted to refine CHD risk assessment in SLE.
Abstract

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