Abstract
ObjectivesCardiovascular risk is increased in patients with systemic lupus erythematosus (SLE). Drugs used to treat SLE can modify traditional cardiovascular risk factors. We examined the effect of selected drugs used in the treatment of SLE on cardiovascular risk factors.MethodsWe compared systolic and diastolic blood pressure, serum lipid concentrations, glucose, homocysteine, and urinary F2-isoprostane concentrations in 99 patients with lupus who were either current users or non-users of systemic corticosteroids, antimalarials, non-steroidal anti-inflammatory drugs (NSAIDs), COX-2 selective NSAIDs, azathioprine, and methotrexate. Multivariable adjustment was done with linear regression modeling using sex, age and disease activity (SLEDAI) as controlling variables.ResultsSerum triglyceride concentrations were higher (135.1 ± 61.4 vs. 95.3 ± 47.5 mg/dL, adjusted P = 0.003) in patients receiving corticosteroids. Homocysteine concentrations were marginally higher in patients receiving methotrexate (adjusted P = 0.08). Current use of either NSAIDs or COX-2 inhibitors was not associated with increased cardiovascular risk factors. Current hydroxychloroquine use was not associated with significant alterations in lipid profiles.ConclusionsIn a non-random sample of patients with SLE, current corticosteroid use was associated with increased triglyceride concentrations, but other drugs had little effect on traditional cardiovascular risk factors.
Highlights
Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis and increased cardiovascular morbidity and mortality [1]
We have found that cardiovascular risk factors such as triglyceride concentrations and the prevalence of hypertension were significantly higher in patients with SLE than controls [2]
The major finding of this study is that current exposure to drugs used to treat SLE is not a major contributor to the cardiovascular risk factors studied
Summary
Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis and increased cardiovascular morbidity and mortality [1]. We have found that cardiovascular risk factors such as triglyceride concentrations and the prevalence of hypertension were significantly higher in patients with SLE than controls [2]. Drugs used to treat the disease, could contribute to alterations in cardiovascular risk factors. Drugs used to treat SLE such as corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors can adversely affect cardiovascular risk factors such as blood pressure and lipid concentrations [3,4,5]. Hydroxychloroquine has been reported to decrease total and LDL cholesterol and triglyceride concentrations [6]. We examined the hypothesis that current use of drugs used to treat SLE affects cardiovascular risk factors
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