Key result
Systemic lupus erythematosus in initially normotensive women was associated with a 43.75% prevalence of masked hypertension and significantly increased intima media thickness (0.833 mm vs 0.66 mm) in those with atherosclerotic plaques compared to healthy controls.
Why the study?
SLE causes a significantly increased risk of cardiovascular disease driven by accelerated atherosclerosis, prompting evaluation of diurnal blood pressure profile disturbances and their correlation with early atherosclerotic markers in normotensive patients.
Does systemic lupus erythematosus increase the risk of abnormal circadian blood pressure profiles and early atherosclerosis in normotensive women without overt heart disease?
Case-Control (n=62)
No
Does systemic lupus erythematosus increase the risk of abnormal circadian blood pressure profiles and early atherosclerosis in normotensive women without overt heart disease?
Absolute Event Rate: 0.833% vs 0.66%
p-value: p=<0.01
Normotensive women with SLE frequently have masked nocturnal hypertension and abnormal circadian blood pressure profiles, which correlate with accelerated subclinical atherosclerosis.
Introduction: Lupus erythematosus (SLE) is an autoimmune disease that causes a significantly increased risk of cardiovascular diseases. This process is underlain by the early and accelerated atherosclerosis. Aim: To assess the diurnal blood pressure profile disturbances in normotensive patients without overt cardiovascular disease and to correlate with early atherosclerotic markers. Material and methods: The study included 32 baseline normotensive women with SLE and 30 healthy control women. Each participant underwent a 24-hour automatic blood pressure measurement and an ultrasound assessment of intima media thickness (IMT) and the presence of carotid atherosclerotic plaques. Results: Atherosclerotic plaques were present in 46.9% of SLE women. They had a significantly higher IMT compared to those without atherosclerotic plaques and control group (0.833 ±0.216 vs. 0.606 ±0.121 vs. 0.66 ±0.16 mm). A significant positive correlation was found between IMT and age of patients, nocturnal systolic blood pressure (SBP), nocturnal systolic pressure (SP) load, nocturnal SBP decline and presence of atherosclerotic plaques. The plaques positively correlated with age and with ambulatory blood pressure monitoring (ABPM) parameters. Fifty percent of SLE women had an abnormal 24-hour BP profile, of which 4 had non-dipper, 8 invers, and 4 hyper-dipper profile. Based on ABPM, hypertension can be diagnosed in 14 (43.75%) initially normotensive women. Women with SLE and arterial hypertension (HA) had atherosclerotic plaques significantly more often, especially in nocturnal hypertension. Conclusions: The authors confirm the underestimation of hypertension in SLE. Most women diagnosed with hypertension by ABPM had nocturnal hypertension. We showed a more frequent disturbed BP and a significant relationship between the abnormal BP profile, especially nocturnal hypertension, and accelerated development of atherosclerosis.
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Poliwczak et al. (2022) conducted a case-control in Systemic lupus erythematosus (n=62). Systemic lupus erythematosus vs. Healthy control women was evaluated on Intima media thickness (IMT) in SLE women with atherosclerotic plaques compared to healthy controls (p=<0.01). Systemic lupus erythematosus in initially normotensive women was associated with a 43.75% prevalence of masked hypertension and significantly increased intima media thickness (0.833 mm vs 0.66 mm) in those with atherosclerotic plaques compared to healthy controls.
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