Risk factors for coronary heart disease in connective tissue diseases

Abstract

Atherosclerosis and cardiovascular disease risk is enhanced in certain connective tissue diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic vasculitis and antiphospholipid syndrome. The reason for this accelerated process is likely to be multifactorial. Traditional risk factors are more prevalent in some of these patient groups compared with the general population (e.g. smoking in RA and hypertension in SLE). However, these factors do not fully explain that enhanced risk. Chronic inflammation associated with these disorders as well as some specific autoantibodies have been shown to contribute to this increased risk although their role remains controversial. The role of therapies is unclear and while steroids may exacerbate metabolic risk factors, the anti-inflammatory effects of traditional and more novel biological therapies may reduce overall cardiovascular risk in these populations. We recommend proactive screening for modifiable cardiovascular risk factors in patients with these conditions.

Subclinical atherosclerosis and peripheral vascular disease in systemic sclerosis patients: Relation to potential risk factors

“…This finding goes in line with many studies which reported a significant increase in the IMT of common carotid arteries than in the controls [5,6,[17][18][19][20][21][22][23][24].…”

“…The role of duplex scanning in the investigation of carotid artery disease is well established, and there is evidence to suggest that it has a predictive role in identifying those patients with a greater than normal risk of stroke [5]. The study of the IMT in other rheumatic diseases on Egyptian patients showed subclinical atherosclerosis in rheumatoid arthritis [9], systemic lupus erythematosus [10], Behc¸ets disease [11] and primary osteoarthritis [12].…”

“…The development of accelerated atherosclerosis in SSc is less clear, however, an increase in carotid IMT in SSc patients has been reported [5,6], clinically there is also little evidence for increased macrovascular complications such as stroke and myocardial infarction in SSc patients [7].…”

Assessment of Prevalence of Dyslipidemia and to Evaluate the Role of Corticosteroids among Patients with Connective Tissue Disorder: Prospective Clinical Study

“…International Journal of Contemporary Medical Research risk factor for cardiovascular disease, reduction in LDL, and increase in VLDL and Triglycerides and reduction in HDL cholesterol. 6 It was found that there is hypercholesterolemia and hypertriglyceridemia in patients with CTDs. In this study, it was found that out of 10 patients who were diagnosed to have RA, 8 patients had dyslipidemia with increase in LDL and Triglycerides being elevated.…”

“…Atherosclerosis lead to CVD and is accelerated in autoimmune diseases such as SLE, Anti-Phospholipid Syndrome (APS) and MCTD. 6 Epidemiological studies have shown elevated LDL levels to be one of the strongest predictors of coronary artery disease. To combat this risk, guidelines have been developed, with LDL as the primary focus for lipid lowering therapy.…”