Prevalence and associated factors of hypertension and major adverse cardiovascular events in lupus nephritis in sub-Saharan Africans

Abstract

Introduction: The prevalence of hypertension in lupus nephritis varies according to studies and can be as high as 74%. The aim of this study was to determine the prevalence of hypertension in lupus nephritis and to search for factors associated with hypertension and the occurrence of major adverse cardiovascular events (MACE).

Materials and methods: This was a multicenter, retrospective, descriptive, and analytical study over a 10-year period from January 1, 2012, to December 31, 2022. It targeted patients followed for lupus nephritis confirmed by anatomo-pathological examination in three nephrology departments in Dakar. We compared hypertensive and non-hypertensive patients to identify hypertension-associated factors.

Results: During the study period, 73 cases of lupus nephritis were collected. In the study population, the mean age was 33.90 years, with a sex ratio of 0.30. The prevalence of hypertension was 40.1%. 23 patients were class III, 25 class IV, and 19 class V. Among hypertensive patients, mean creatinine was 33.7 mg/L, and renal failure was present in 56.66% of patients. Mean proteinuria was 5.42 g/24h. Hypertension-associated factors were age (OR = 1.15, 95% CI: 1.05 - 2.25; p = 0.001), renal failure (OR = 12.872, 95% CI: 2.23 - 74.28; p = 0.004), and proliferative class (OR = 18.83, 95% CI: 1.91 - 185.25; p = 0.012). For the cardiovascular events, there were 3 cases of stroke, 0 cases of heart attack, and 0 cardiovascular deaths.

Conclusion: Hypertension in lupus nephritis is common in our setting. Hypertension-associated factors were related to advanced age and severity of lupus nephritis. Long-term follow-up would be necessary to better detect cardiovascular events.