Lupus Patients Have Increased Risk of Cardiovascular and Metabolic Disease, Study Shows

Patients with systemic lupus erythematosus have an increased risk for cardiovascular and metabolic diseases — a risk that they share with patients who have other chronic inflammatory conditions, according to a study published in the journal Heart.

Those taking non-steroidal anti-inflammatory drugs or corticosteroids appeared to have a particularly heightened risk, the study from King’s College London in the U.K., demonstrated.

The findings indicate that researchers need to focus on the development of clinical guidelines that aim to prevent cardiovascular disease in people with inflammatory disease in general, and lupus patients in particular, as those with lupus had the highest risk of all patient groups.

Earlier research had already indicated that patients with inflammatory conditions were more prone to develop cardiovascular or metabolic disease, such as stroke, type 2 diabetes, or venous thromboembolism.

The research team had previously studied patients in a primary care setting, and found increased rates of those conditions in patients with inflammation. But it was not certain if the findings could be applied to a community-based population, where patient and disease factors tend to be more varied.

The study, “Cardiovascular and type 2 diabetes morbidity and all-cause mortality among diverse chronic inflammatory disorders,” used data from the U.K. Biobank — a prospective study that gathers medical and demographic information — to assess risk of disease and mortality.

Among the 502,641 participants, 4 percent, or 19,082 individuals, had a diagnosis of lupus or another inflammatory disease. Psoriasis was the most common diagnosis, and lupus the least common, with only 654 affected patients.

Other included diseases were ankylosing spondylitis, Crohn’s disease, rheumatoid arthritis, vasculitis, and ulcerative colitis.

Lupus patients turned out to be among the most affected, with 4 percent having multiple cardiovascular or metabolic events. The one exception was type 2 diabetes, which was more common in people with other inflammatory conditions. Their risk of cardiometabolic disease was more than six times higher than people without any inflammatory condition.

The team noted that patients tended to have certain combinations of diseases — coronary heart disease was often found with either type 2 diabetes, venous thromboembolism, or stroke.

Lupus patients who took nonsteroidal anti-inflammatory drugs or corticosteroid had an even higher risk of cardiometabolic disease — more than 12 times higher than people without inflammatory disease and who did not take such medications.

In line with these findings, analyses showed that lupus patients also had the highest all-cause, and cardiometabolic-related mortality among the studied participants.

Researchers noted that an ongoing study at the U.K. Biobank is collecting data that can shed more light on the relationship between lupus and cardiometabolic disease. Such studies might in time provide insights into how heart or metabolic conditions in these patients can best be prevented, or managed if they develop.