Cardiovascular risk factor screening in systemic lupus erythematosus

Abstract

Objective: To evaluate the frequency of cardiovascular (CV) disease risk factor screening in systemic lupus erythematosus (SLE).

Methods: Medical records of patients from a lupus clinic and 5 private practices were assessed for CV disease risk factors, including hyperlipidemia, hypertension, diabetes mellitus, smoking, family history of CV disease, antiphospholipid antibodies, hyperhomocysteinemia, postmenopausal status, obesity, and nephrotic syndrome.

Results: A total of 183 records were included: 60 (33%) from the lupus clinic and 123 (67%) from private practices. Serum lipid profiles were measured in 56/183 (31%): 37/60 (62%) in the lupus clinic vs 19/123 (15%) private practice. Of the 56 with lipids measured, the individual tests obtained were as follows: total cholesterol in 56 (100%), HDL in 50 (89%), triglycerides in 49 (88%), LDL in 48 (86%), and VLDL in 33 (59%). Thirty-one of 56 patients (55%) had elevated lipids. Only 9/25 (36%) with hyperlipidemia who had a subsequent visit had a response to the hyperlipidemia charted. Of 9 nonlipid risk factors, a median of 8 were assessed in the lupus clinic vs 3 in private practices. The most frequent risk factors screened were nephrotic syndrome (91%), hypertension (74%), and smoking (59%).

Conclusion: Despite an inordinately high risk of CV disease in SLE, assessment of CV risk factors was surprisingly uncommon among the practices assessed. Greater attention needs to be paid to CV disease risk factor screening in patients with lupus.