Cardiac risk factor awareness and management in patients with systemic lupus erythematosus

OBJECTIVE: To assess awareness and management of traditional cardiac risk factors (CRFs) in patients with systemic lupus erythematosus (SLE) and physicians. METHODS: SLE patients (n=110) completed a questionnaire concerning CRFs. Medical records were reviewed blinded to questionnaire results for the presence and management of 6 CRFs: hypertension, hypercholesterolemia, smoking, obesity, diabetes mellitus, and physical inactivity. RESULTS: Subjects were predominantly female (97%), mean (+/-SD) age was 43.4 years (+/-11.8), mean SLE duration was 15.3 years (+/-7.2), and 51% had > or =2 CRFs by self report. Twenty-three percent had never had their cholesterol levels checked. Hypercholesterolemia was more frequently documented in the medical records than reported by the patient (33% versus 24%). Physical inactivity was more frequently self reported than documented (59% versus 23%). Rheumatologists and patients had low interrater reliability for the presence of hypercholesterolemia (kappa=0.26) and physical inactivity (kappa=-0.02). More than half (58%) of CRFs were treated, and 21% of subjects with elevated cholesterol received a medication. CONCLUSION: Recognition, recording, and management of CRFs falls short given the significance of the problem.