Blood pressure control over time in childhood-onset systemic lupus erythematous

Area of Science:

• Pediatric Rheumatology
• Cardiovascular Health
• Nephrology

Background:

• Hypertension (HTN) is a significant comorbidity in systemic lupus erythematosus (SLE), contributing to accelerated cardiovascular aging and organ damage.
• Childhood-onset SLE (cSLE) presents unique challenges, with HTN potentially impacting disease progression and long-term outcomes.

Purpose of the Study:

• To determine the prevalence and trends of HTN in a cohort of patients with cSLE.
• To identify risk factors associated with the development of HTN in this population.

Main Methods:

• A longitudinal retrospective study analyzing electronic medical records of cSLE patients.
• Data collection included demographic, clinical, and blood pressure measurements from baseline to last follow-up.

Main Results:

• The study identified 110 cSLE patients with a median follow-up of 29.5 months.
• At baseline, 29% had HTN and 23% had pre-HTN. Patients with HTN showed higher disease activity, obesity, lupus nephritis (LN), and lower eGFR.
• Multivariate analysis revealed LN, obesity, and high extra-renal disease activity as independent predictors of baseline HTN.

Conclusions:

• HTN is prevalent and persistent in cSLE, even in the absence of lupus nephritis.
• Approximately one-third of cSLE patients had uncontrolled elevated blood pressure nearly three years post-diagnosis.
• Obesity and high overall disease activity are significant independent predictors of HTN in cSLE, alongside lupus nephritis.