Cardiovascular risk factors and carotid atherosclerosis in patients with systemic lupus Erythematosus at the Kenyatta National Hospital
Abstract
Background: Cardiovascular disease is now acknowledged as a primary cause of morbidity
and mortality in patients with systemic lupus erythematosus (SLE). The risk of developing
coronary artery disease in these patients is four to eight times higher than that in the normal
population. There has been paucity of data regarding cardiovascular risk in SLE patients in our
setting.
Objective: To determine the prevalence of selected cardiovascular risk factors and carotid
atherosclerosis in patients with systemic lupus erythematosus.
Methodology: This was a cross-sectional survey carried out in patients with SLE and age- and
sex-matched controls at the Kenyatta National Hospital. The SLE patients underwent clinical
assessment with measurement of their blood pressure, weight, height, waist and hip
circumferences. They also underwent laboratory testing to determine their fasting blood sugar
and fasting lipid profile. In addition, carotid Doppler ultrasonography was done for the lupus
patients. The controls had similar clinical and laboratory assessment done as for controls. Carotid
ultrasonography was however not done for controls.
Results: Sixty six SLE patients and 66 healthy controls participated in this study. The mean
age of the patients was 35.9 years, with a female to male ratio of 21:1 and a median duration of
illness of two years. Hypertension prevalence was 42.4% in the patients and 24.2% in the
controls (p=0.027), dyslipidemia occurred in 74.2% of the patients and 62.1% of the controls
(p=0.135) while the prevalence of diabetes was 4.5% in patients and 1.5% in controls (p=0.619).
Obesity by BMI assessment was found in 12.1% of patients and 21.2% of the controls (p=0.330)
whereas abdominal obesity (by waist: hip ratio) occurred in 33.3% of patients and 24.2% of
controls (p=0.249). Carotid atherosclerosis occurred in 19patients (28.8%) and was associated
with longer duration of illness (p=0.040). Correlation between obesity (by BMI assessment) and
longer disease duration was also found (p=0.021).
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Conclusion: There was a high prevalence of atherosclerosis and selected cardiovascular risk
factors in this population of SLE patients. Hypertension was significantly more common in the
lupus patients than controls. Cardiovascular risk assessment and appropriate treatment of risk
factors identified should be enhanced in patients with SLE.
Publisher
University Of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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