People with the autoimmune disease lupus may develop carotid atherosclerosis (the buildup of fatty deposits in the arteries) at an accelerated rate and independently of many risk factors normally associated with cardiovascular disease, according to a new study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health. The work was reported in the December 18 issue of the New England Journal of Medicine.
The study, carried out by Mary J. Roman, M.D., at Weill Medical College of Cornell University, Jane E. Salmon, M.D., at the Hospital for Special Surgery (N.Y.), and their colleagues examined 197 people with lupus and the same number of matched controls. Risk factors for cardiovascular disease, including family history of heart disease, cholesterol levels, smoking and hypertension, were similar in both groups, but atherosclerosis, as evidenced by carotid ultrasound, was more prevalent in lupus patients. The scientists also found that people with lupus who had the disease longer, had more damage from the disease, and had used less of the immunosuppressive drug cyclophosphamide to treat it were more likely to develop fatty deposits in their arteries.
“Although we’ve known for some time that there is an association between lupus and premature heart attacks,” said NIAMS Director Stephen I. Katz, M.D., Ph.D. “until now we haven’t understood well the reasons. This study gives us a basis to pursue intervention strategies for reducing cardiovascular risks.”
Lupus (systemic lupus erythematosus) is a rheumatic disease that can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain. People who have lupus may have many different symptoms, but some of the most common ones include extreme fatigue, painful or swollen joints (arthritis), unexplained fever, skin rashes and kidney problems. Many more women than men have lupus. It is three times more common in African American women than in Caucasian women and is also more common in women of Hispanic, Asian and Native American descent.
Funding for this study was also provided by the National Heart, Lung, and Blood Institute and the National Center on Minority Health and Health Disparities, which along with NIAMS are parts of the Department of Health and Human Services’ (DHHS) National Institutes of Health; DHHS’ Public Health Service; the Mary Kirkland Center for Lupus Research at the Hospital for Special Surgery; and the Bugher Foundation.
To contact Dr. Roman, call Jonathan Weil at the Weill Medical College of Cornell University at (212) 821-0566. To contact Dr. Salmon, call Chris Godek at the Hospital for Special Surgery at (212) 606-1197.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services’ National Institutes of Health, is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS Web site at http://www.niams.nih.gov.
Reference: Roman MJ, et al. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. NEJM 2003;349:2397-2404.