Systemic lupus erythematosus is an independent risk factor for early-onset, severe atherosclerosis, according to an article in the December 18th issue of the New England Journal of Medicine.

American researchers led by Mary J. Roman, MD, examined 197 people with lupus and 197 matched controls. Risk factors for cardiovascular disease including family history, cholesterol levels, and the prevalence of smoking and hypertension were similar for both groups. However, atherosclerosis per carotid ultrasound was more prevalent in lupus patients. In addition, increases in duration of lupus, extent of lupus-related tissue damage, or both correlated with increased atherosclerosis. Patients who had used less cyclophosphamide as treatment for their lupus were also more likely to develop atherosclerosis.

"Although we've known for some time that there is an association between lupus and premature heart attacks," said Stephen I. Katz, M.D., Ph.D., of the National Institutes of Health, "until now we haven't understood well the reasons. This study gives us a basis to pursue intervention strategies for reducing cardiovascular risks."

Because lupus is far more common in women than men, identification of women with lupus as high risk for premature atherosclerosis may improve preventive care and clinical monitoring of this vulnerable population. In the U.S., lupus is more common in women of African or Asian descent than in Caucasian women; thus, early identification of lupus in these women may improve both their rheumatologic and cardiovascular care.