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Risk factors for coronary heart disease in connective tissue diseases

Awal Al Husain1, Ian N Bruce

  • 1arc Epidemiology Unit, School of Translational Medicine, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK, The Kellgren Centre for Rheumatology, Central Manchester Foundation Trust, Manchester, UK.

Therapeutic Advances in Musculoskeletal Disease
|August 8, 2012
PubMed

Insights

Patients with connective tissue diseases face higher cardiovascular disease risk due to multifactorial causes including inflammation. Proactive screening for modifiable risk factors is recommended for these patients.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Immunology

Background:

  • Connective tissue diseases like systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are associated with enhanced atherosclerosis and cardiovascular disease (CVD) risk.
  • Traditional CVD risk factors are more prevalent in these patient groups, but do not fully account for the elevated risk.
  • Chronic inflammation and specific autoantibodies may contribute to increased CVD risk, though their roles are debated.

Purpose of the Study:

  • To explore the multifactorial reasons behind accelerated atherosclerosis and CVD risk in patients with specific connective tissue diseases.
  • To evaluate the impact of traditional risk factors, chronic inflammation, autoantibodies, and therapies on CVD risk in these populations.

Main Methods:

  • Review of existing literature on cardiovascular risk in connective tissue diseases.
  • Analysis of the prevalence of traditional risk factors in patient cohorts.
  • Discussion of the potential roles of chronic inflammation, autoantibodies, and therapeutic interventions.

Main Results:

  • Accelerated atherosclerosis and CVD risk are observed in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic vasculitis, and antiphospholipid syndrome.
  • While traditional risk factors are more common, they don't fully explain the enhanced CVD risk.
  • Chronic inflammation and certain autoantibodies are implicated, but their exact contribution requires further research.
  • Therapies present a complex picture: steroids may worsen metabolic risk, while anti-inflammatory treatments might reduce overall CVD risk.

Conclusions:

  • The enhanced cardiovascular risk in connective tissue diseases is multifactorial, involving both traditional and disease-specific factors.
  • Proactive screening for modifiable cardiovascular risk factors is crucial for patients diagnosed with these conditions.
  • Further research is needed to clarify the precise roles of inflammation, autoantibodies, and therapies in modulating cardiovascular risk.

Keywords:
atherosclerosiscardiovascular diseaseconnective tissue diseaserisk factors

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