シェーグレン病患者における心血管リスク因子の管理：包括的アプローチ

Sjögren's disease (SjD) is a systemic autoimmune disease primarily affecting exocrine glands, but increasingly recognized for its association with elevated cardiovascular risk. Chronic inflammation, immune dysregulation, and metabolic disturbances contribute to this burden. To summarize the mechanisms linking SjD to cardiovascular disease (CVD) and propose evidence-based strategies for risk assessment and management, we reviewed the current literature on immune-mediated vascular dysfunction, autoantibody profiles, dyslipidemia, hypertension, insulin resistance, and lifestyle factors in SjD. It also evaluates pharmacologic and non-pharmacologic interventions. SjD patients exhibit both traditional and disease-specific cardiovascular risk factors. Autoantibody positivity (anti-Ro/SSA and anti-La/SSB) correlates with increased risk of thrombotic events. Systemic inflammation and endothelial dysfunction are central to pathogenesis. Statins, ACE inhibitors, and metformin show promise in mitigating risk. Lifestyle interventions, including Mediterranean diet and aerobic exercise, offer additional benefits. Thus, cardiovascular risk management should be an integral part of SjD care. A multidisciplinary approach combining clinical evaluation, targeted therapies, and lifestyle modification is essential to reduce morbidity and improve outcomes.