The cardiovascular system, also known as the circulatory system, is responsible for circulating blood throughout the body. This system helps fight disease, stabilizes the body’s temperature, regulates the pH balance, maintains homeostasis, and delivers nutrients to organs and cells.
Essential elements of the cardiovascular system include the:
- Heart
- Blood vessels
- Blood
- Lungs
- Kidneys
Lupus & Cardiovascular Disease
Many studies have shown that people with lupus are at an increased risk of cardiovascular disease. In fact, one study that is referenced by the Lupus Research Alliance notes that women with lupus between 35-45 years old are 50x more likely to have a myocardial infarction (also known as a heart attack). For people with lupus not in that demographic range, the risk is increased 7- to 9-fold.
(This study used the Framingham Heart Study as a comparator. This study began in 1948 and followed 3 generations of people to understand how cardiovascular health impacts the rest of the body. It identified that high blood pressure and high blood cholesterol are major risk factors of cardiovascular disease, and has lead to around 3,000 research publications.)
Subsequent studies have explored the connection between lupus and cardiovascular disease have found similar, although typically less severe, links. One found that people with lupus were twice as likely to have cardiovascular disease as control participants. This is worrisome because it is a leading causes of mortality for people with lupus.
Recent efforts by researchers at the National Institute of Arthritis and Musculoskeletal and Skin Diseases may have identified the reason for the increased cardiovascular risk for Lupus Warriors. The researchers found that the improperly functioning immune system cells that are a hallmark of lupus (and other autoimmune diseases) also damage cells in the arteries of the heart.
Unfortunately, common medications for the treatment of lupus including immunosuppressants and corticosteroids include side effects. A 2009 study highlighted how these medications may increase blood pressure, cholesterol, and body mass.
With regard to medications, the Lupus Foundation of America shares that it is safe to take most high blood pressure medications with lupus (except for hydralazine “which has been shown to induce activation of T cells and is known to cause drug-induced lupus”). Check with your lupus treatment team if you have any questions or concerns about your medications.
What is Cardiovascular Disease?
Cardiovascular disease is a broad term used to describe all types of diseases or afflictions of the heart and blood vessels. In general, these are conditions that involve the narrowing or blocking off blood vessels. This includes:
- Coronary heart disease (clogged arteries)
- Chest pain (angina)
- Strokes
- Atherosclerosis
- Pericarditis
- Endocarditis
- Congenital heart defects
- Peripheral artery disease
Each year in the United States, about 1 in 3 deaths is caused by cardiovascular disease. It is extremely important to be aware of the risk factors
Specific Cardiovascular Diseases & Lupus
Atheroscloerosis
Frequency with SLE: Most common manifestation of cardiovascular disease
What it is: Accumulation of plaque and cholesterol in the arteries. When the plaque hardens, it restricts blood flow to the heart and brain.
Contributing factors: Smoking; obesity; high blood pressure
Pericarditis
Frequency with SLE: About 25% of people with lupus
What it is: Pericardium (the membrane around the heart) swells, becomes irritated, and leaks fluid
Symptoms: Pain in the chest that is worse when lying down
Treatment: Often NSAIDs or steroids
Endocarditis
Frequency with SLE: About 15% of people with lupus (Libman-Sacks endocarditis)
What it is: Growths (known as vegetations) on the heart valves that can lead to infection and stroke.
Treatment: Anticoagulants
NOTE: When receiving dental work, it is possible for bacteria to pass through the blood and exacerbate this risk. Speak with a doctor prior to seeing a dentist if you have a severe heart murmur.
Myocarditis
Frequency with SLE: Less than 10% of people
What it is: Rapid heart beat, chest pains, and an enlarged heart that weaken the heart
Treatment: Closely monitored by a doctor and treated with high dose steroids
5 Strategies to Reduce Cardiovascular Disease Risk
- Eat a healthy diet
- 3 – 5 portions of fruit and vegetables everyday
- Eat whole grain, high-fiber foods
- Limit alcohol
- Exercise regularly
- Be sure to not over-do it and to clear it with your lupus treatment team
- Stop smoke tobacco
- Maintain a healthy BMI (body mass index)
- Monitor and work to reduce your blood pressure if it is over 120/80 mmHg
7 thoughts on “Cardiovascular Health & Lupus: Managing the Risk”
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Thank you for all this great information on Lupus. Sometimes we think we are battling this alone.
I’ve learned alot from these little deals. I’m going through several of the things that have been posted lately. I appreciate the info.
Thank you for all the information about symptoms, medications and treatment options for lupus (All types of autoimmune disorders).
It is extremely reassuring to realize that I am not alone, that someone DOES understand the daily struggle. Even spouses who are supportive often still do not grasp the true depth of the fatigue and pain of just getting through the day.
My husband tries to understand, i know i am lucky and blessed to have him. However, sometimes when i comment about a struggle he just poo- poo’s me, like “oh, it’s not as hard as you think just try harder”. He doesn’t “get” that i give 150% EVERYDAY. Not just the days i happen to mention i am struggling. EVERYDAY.
So knowing there are others who DO “Get it” really helps mentally. I am not crazy.
I fear that my grandchildren will only remember me as the crazy, sick grama who was always complaining about pain and being tired.
I used to be the “Fun” grama, trips to the beach, parks, Disneyland. That changed almost overnight after a major car accident. I had symptoms for many years prior to this car accident however, i had managed them without medications for 10 years. It was like someone turned on the light switch and i haven’t been able to turn it off… for the last 15 years. Not sure if the stress, the medications for the broken bones, age or what set of the major flair but it has been overwhelming ever since.
I mourn the freedom of being pain and fatigue free.
I mourn the loss of being able to physically and mentally doing what i was capable of doing prior to that dreadful day.
Thank you for listening, for caring. I hope you know what a blesding you give to other warriors daily. Through the information, advise, listening and support that your site provides for us.
Bless you and stay strong warrior!!
Hi Christy,
Thank you for being part of the community and taking the time to share your experiences. I’m sorry to hear about your challenges and truly hope all the best for you. Your strength is definitely understood here!
We want the LupusCorner articles to be as useful as possible – if there are topics you’d like covered, please let me know.
Also, if you are interested in contributing to the LupusCorner Q&A Forum you can email hello@lupuscorner.com
-Brett
50 TIMES greater risk is not the same as “50%” greater risk. I greatly appreciate this website but mixing up a 50 times greater risk as only a .50 greater risk is not helpful to educating about lupus. The risk of heart attack or coronary artery disease in SLE patients is ENORMOUS, and all SLE patients should have themselves checked for plaque and hypertension regularly. The steroid treatments increase the risk exponentially as well, not FRACTIONALLY. I fight to convince my primary care doctors to run screening tests like this because they think the risk elevation is marginal when it is not. Thank you for this website!
Hi Jennifer — thanks for reading and being part of the LC community! You’re correct – it looks like the article says ’50x’ but the Newsletter had used the phrase “increased risk by 50% or more.” Considerably (and importantly!) different as you pointed out!
-Brett
Seems you skipped Pulmonary Hypertension. In my past 12 years of dealing with it, seems to like a good Lupus patient now and again. I’ve had Lupus for 30+ years and have a pretty good relationship with my Dr.s and I’m seen at a Major Medical Institution and I couldn’t get a PH diagnosis without frustration. It took me over 3 years for someone to finally get it right. I was given Pericarditis, Myocarditis, lose weight, exercise, PE, lung fungus (some weird name), and a bunch of excuses even though my sitting O2 was in the mid ’80s. More people and Dr’s need to know what to look for in their patients, it’s no fun gasping for air while your heart races at the same time.