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Modification of hypertension and hypercholesterolaemia in patients with systemic lupus erythematosus: a quality

M B Urowitz1, D D Gladman, D Ibanez

  • 1Rheumatology Department, University Health Network, Toronto Western Hospital, Canada. m.urowitz@utoronto.ca

Annals of the Rheumatic Diseases
|December 14, 2005
PubMed

Insights

Treatment for hypertension and hyperlipidaemia improved in systemic lupus erythematosus (SLE) patients after a quality improvement initiative. However, some eligible SLE patients still do not receive necessary treatments for these cardiovascular risk factors.

Area of Science:

  • Cardiology
  • Rheumatology
  • Clinical Quality Improvement

Background:

  • Systemic lupus erythematosus (SLE) patients face elevated risks of coronary artery disease due to hypercholesterolaemia and hypertension.
  • Effective management of these cardiovascular risk factors is crucial for SLE patient outcomes.

Purpose of the Study:

  • To evaluate the impact of a quality improvement study on the recognition and management of hypercholesterolaemia and hypertension in SLE patients.
  • To compare treatment rates before and after the quality improvement intervention.

Main Methods:

  • Prospective follow-up of patients at the University of Toronto Lupus Clinic since 1970.
  • Chart review of SLE patients entering the clinic from 1990-2001 to assess anti-hypertensive (AHT) and lipid-lowering agent (LLA) use.
  • Comparative analysis of treatment data for two periods: 1990-1995 and 1996-2001.

Main Results:

  • Hypertension prevalence increased from 36% (1990-1995) to 42% (1996-2001), with AHT use rising from 88% to 96%.
  • Treatment for hypercholesterolaemia with LLA significantly increased from 9% (1990-1995) to 28% (1996-2001).
  • Statistical significance was achieved for both improved hypertension (p=0.0013) and hypercholesterolaemia treatment rates (p<0.0001).

Conclusions:

  • The quality improvement study demonstrated a significant increase in the treatment of hypertension and hyperlipidaemia among SLE patients.
  • Despite improvements, a notable proportion of SLE patients who are eligible for treatment for these conditions remain untreated.
Abstract

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