High Lupus Mortality in African Americans May Be Preventable

African Americans are two to three times more likely to die from systemic lupus erythematosus than are whites, a disparity that is higher than the risk of mortality from all causes, according to an analysis of U.S. death and hospitalization statistics.

Dr. Eswar Krishnan of the University of Pittsburgh and Helen B. Hubert, Ph.D., of Stanford (Calif.) University wrote that the greater lupus mortality risk suggests that biologic rather than socioeconomic factors may be responsible.

The study examined death statistics from the National Center for Health Statistics at the Centers for Disease Control and Prevention from 1979 to 1998. Investigators also analyzed data from the Nationwide Inpatient Sample, a database run by the Agency for Healthcare Research and Quality taken from the discharge summaries of a 20% stratified sample of hospitals in the United States from 1993 to 2002 (Ann. Rheum. Dis. 2006;[Epub ahead of print, doi:10.1136/ard.2005.040907]).

For African American women, the lupus mortality risk was 3.91 times that of white women, compared with 1.24 for death from all causes. For African American men, the lupus mortality risk was 2.4 times that of white men, compared with 1.36 for deaths from all causes.

The mean age at which women were hospitalized for lupus was 43 years for African Americans and 53 years for whites. For men, the mean age at hospitalization for lupus was 43 years for African Americans and 58 years for whites. For lupus patients who died, the mean age among African Americans was 49 years; for whites, the mean age was 64 years.

The lupus death rate increased for both African American and white women from 1979 to 1998. The death rate for African American men held steady while decreasing for white men, which resulted in an increase in the relative death risk ratio for African American men.

Insurance status did not influence relative mortality risk, suggesting that the ethnic differences may be biologic, the researchers said. Such a suggestion is supported by research indicating that African Americans are diagnosed with lupus 6 years younger than are whites on average and were more likely to show such symptoms as discoid lupus.

“Our findings have important clinical and public health implications,” the investigators wrote, adding that African Americans are less likely to receive preventative health services than are whites. Therefore, many of the excess deaths among African Americans with lupus may be the result of preventable cardiovascular, infectious, and renal complications. Aggressive intervention with increased exercise, control of hypertension and hyperlipidemia, smoking cessation, and management of other risk factors may eliminate the excess mortality seen in African Americans with lupus, according to the investigators.

African Americans are two to three times more likely to die from systemic lupus erythematosus than are whites, a disparity that is higher than the risk of mortality from all causes, according to an analysis of U.S. death and hospitalization statistics.

Dr. Eswar Krishnan of the University of Pittsburgh and Helen B. Hubert, Ph.D., of Stanford (Calif.) University wrote that the greater lupus mortality risk suggests that biologic rather than socioeconomic factors may be responsible.

The study examined death statistics from the National Center for Health Statistics at the Centers for Disease Control and Prevention from 1979 to 1998. Investigators also analyzed data from the Nationwide Inpatient Sample, a database run by the Agency for Healthcare Research and Quality taken from the discharge summaries of a 20% stratified sample of hospitals in the United States from 1993 to 2002 (Ann. Rheum. Dis. 2006;[Epub ahead of print, doi:10.1136/ard.2005.040907]).

For African American women, the lupus mortality risk was 3.91 times that of white women, compared with 1.24 for death from all causes. For African American men, the lupus mortality risk was 2.4 times that of white men, compared with 1.36 for deaths from all causes.

The mean age at which women were hospitalized for lupus was 43 years for African Americans and 53 years for whites. For men, the mean age at hospitalization for lupus was 43 years for African Americans and 58 years for whites. For lupus patients who died, the mean age among African Americans was 49 years; for whites, the mean age was 64 years.

The lupus death rate increased for both African American and white women from 1979 to 1998. The death rate for African American men held steady while decreasing for white men, which resulted in an increase in the relative death risk ratio for African American men.

Insurance status did not influence relative mortality risk, suggesting that the ethnic differences may be biologic, the researchers said. Such a suggestion is supported by research indicating that African Americans are diagnosed with lupus 6 years younger than are whites on average and were more likely to show such symptoms as discoid lupus.

“Our findings have important clinical and public health implications,” the investigators wrote, adding that African Americans are less likely to receive preventative health services than are whites. Therefore, many of the excess deaths among African Americans with lupus may be the result of preventable cardiovascular, infectious, and renal complications. Aggressive intervention with increased exercise, control of hypertension and hyperlipidemia, smoking cessation, and management of other risk factors may eliminate the excess mortality seen in African Americans with lupus, according to the investigators.

African Americans are two to three times more likely to die from systemic lupus erythematosus than are whites, a disparity that is higher than the risk of mortality from all causes, according to an analysis of U.S. death and hospitalization statistics.

Dr. Eswar Krishnan of the University of Pittsburgh and Helen B. Hubert, Ph.D., of Stanford (Calif.) University wrote that the greater lupus mortality risk suggests that biologic rather than socioeconomic factors may be responsible.

The study examined death statistics from the National Center for Health Statistics at the Centers for Disease Control and Prevention from 1979 to 1998. Investigators also analyzed data from the Nationwide Inpatient Sample, a database run by the Agency for Healthcare Research and Quality taken from the discharge summaries of a 20% stratified sample of hospitals in the United States from 1993 to 2002 (Ann. Rheum. Dis. 2006;[Epub ahead of print, doi:10.1136/ard.2005.040907]).

For African American women, the lupus mortality risk was 3.91 times that of white women, compared with 1.24 for death from all causes. For African American men, the lupus mortality risk was 2.4 times that of white men, compared with 1.36 for deaths from all causes.

The mean age at which women were hospitalized for lupus was 43 years for African Americans and 53 years for whites. For men, the mean age at hospitalization for lupus was 43 years for African Americans and 58 years for whites. For lupus patients who died, the mean age among African Americans was 49 years; for whites, the mean age was 64 years.

The lupus death rate increased for both African American and white women from 1979 to 1998. The death rate for African American men held steady while decreasing for white men, which resulted in an increase in the relative death risk ratio for African American men.

Insurance status did not influence relative mortality risk, suggesting that the ethnic differences may be biologic, the researchers said. Such a suggestion is supported by research indicating that African Americans are diagnosed with lupus 6 years younger than are whites on average and were more likely to show such symptoms as discoid lupus.

“Our findings have important clinical and public health implications,” the investigators wrote, adding that African Americans are less likely to receive preventative health services than are whites. Therefore, many of the excess deaths among African Americans with lupus may be the result of preventable cardiovascular, infectious, and renal complications. Aggressive intervention with increased exercise, control of hypertension and hyperlipidemia, smoking cessation, and management of other risk factors may eliminate the excess mortality seen in African Americans with lupus, according to the investigators.