Depression, anxiety higher in lupus patients at risk of heart disease
Obesity, diabetes, hypertension among conditions raising a cardiovascular risk
Depression and anxiety are more likely in people with systemic lupus erythematosus (SLE) who also are at a greater risk of heart disease, like those with obesity or high blood pressure, a study reports.
“The findings of this study suggest the need for more intensive and global care, particularly regarding mental health, when considering SLE patients with a high cardiovascular risk profile,” its researchers wrote.
The study, “Quality of life, fatigue, sleep quality, and mental health in systemic lupus erythematosus patients with a high cardiovascular risk profile,” was published in the journal Lupus.
Depression and anxiety generally higher in people at heart disease risk
People with lupus are known to have conditions that increase the risk of heart disease, such as obesity, diabetes, hypertension (high blood pressure), and dyslipidemia (high blood fat levels), at higher rates that the general public.
But across the public at large, these conditions also link with a higher likelihood of mental health problems and a poorer life quality. How these comorbidities, or co-occurring conditions, affect life for people with SLE, however, often has not been studied.
A team of scientists in Brazil conducted a study to learn more as part of a larger clinical trial (NCT04431167) into physical activity and healthy diet among people with lupus and one or more cardiovascular disease risk factors.
“Understanding SLE patients’ quality of life and psychological symptoms is of utmost importance to improve disease management,” the scientists wrote, adding that “the aim of the study is to describe [health-related quality of life], fatigue, mental health, and sleep quality in a sample of SLE patients with a high cardiovascular risk profile.”
They enrolled 100 SLE patients with heart disease risk factors, most of whom were overweight or obese. Patients, at an average age of 41.7, were surveyed about their life quality, mental health, and fatigue levels, and most also completed a sleep study where an accelerometer (a device that tracks movement) was worn on the wrist a few nights during sleep.
Findings then were compared with data from prior studies that assessed similar outcomes in lupus patients without cardiovascular risk factors.
Depression reported in 93% of at-risk lupus patients, anxiety in 78%
Measures of life quality, as well as assessments of sleep quality and fatigue, generally were comparable among SLE patients with and without heart disease risk factors, results showed. However, patients with risk factors reported markedly higher rates of anxiety and depression.
Specifically, 78% of lupus patients with cardiovascular risk factors reported clinically relevant anxiety, and 93% had depression. In contrast, prior studies in SLE patients without such risk factors suggest that 28% to 52% have anxiety and 30% to 69% have depression.
“We observed a remarkably high prevalence of depression and anxiety symptoms in our sample when compared to other studies with SLE patients,” the researchers wrote.
Because cardiovascular risk factors like obesity have been linked with mental health issues in the general population, the high rates of anxiety and depression here “could be partially explained by the presence of high cardiovascular risk conditions,” the researchers wrote.
Among noted study limitations were assessing patients at only one point in time, and not including a comparison patient group without cardiovascular risk factors. Findings were compared against those of other studies, which can limit the accuracy of this study’s conclusions.
Still, the scientists said these findings highlight the importance of providing mental health care for people with SLE, particularly those with cardiovascular health issues.
A need exists “for more intensive and global care regarding mental health when considering a high cardiovascular risk in SLE,” the scientists concluded.