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Nurses Health Study: SLE Doubles Heart Disease Risk

SAN FRANCISCO — Systemic lupus erythematosus more than doubles a woman's relative risk for cardiovascular disease beyond the effect of traditional determinants, judging from the Nurses Health Study findings.

Earlier research reports have found a significantly greater than twofold increased risk for cardiovascular disease in women with lupus. However, those studies examined risk in lupus populations receiving care at tertiary care centers. The data from this study came from a study of the general population, according to investigator Dr. A. Elisabeth Hak.

The Nurses Health Study includes 121,700 women who enrolled in the prospective cohort study in 1976, when they were between 30 and 55 years old. They had no cardiovascular disease (CVD) or SLE at enrollment. Over 28 years, 148 developed SLE. Hypertension, diabetes, family history of CVD, and NSAID use were more common in the women with SLE and heart disease than in the SLE-free women with heart disease.

There were 20 cases of CVD (16 cases of heart disease and 4 strokes) among the women with SLE and 8,149 (6,254 cases of heart disease and 1,895 strokes) among the non-SLE group, said Dr. Hak, reporting on the investigation she conducted while at Brigham and Women's Hospital, Boston. Based on follow-up of 2,082 person-years for the women with SLE and 2,932,407 person-years for the SLE-free women, the incidence of CVD was 961 cases per 100,000 person-years for the SLE group and 271 per 100,000 person-years for the non-SLE group.

The age-adjusted relative risk for CVD was 2.75 in the SLE group, versus the non-SLE group. The multivariate-adjusted relative risk was 2.26 in the SLE women relative to the women without SLE after controlling for medication use, age, hypertension, race, diabetes, and serum lipid levels, reported Dr. Hak, now at Erasmus University Medical Centre, Rotterdam (the Netherlands).

The fact that the study enrolled women aged 30–55 years means that it excluded those with younger-onset SLE, in whom CVD may have been more common and severe, she noted at the annual meeting of the American College of Rheumatology. The findings also may have been affected by the fact that the cohort is overwhelmingly white.

Dr. Hak reported having no financial conflicts of interest.

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SAN FRANCISCO — Systemic lupus erythematosus more than doubles a woman's relative risk for cardiovascular disease beyond the effect of traditional determinants, judging from the Nurses Health Study findings.

Earlier research reports have found a significantly greater than twofold increased risk for cardiovascular disease in women with lupus. However, those studies examined risk in lupus populations receiving care at tertiary care centers. The data from this study came from a study of the general population, according to investigator Dr. A. Elisabeth Hak.

The Nurses Health Study includes 121,700 women who enrolled in the prospective cohort study in 1976, when they were between 30 and 55 years old. They had no cardiovascular disease (CVD) or SLE at enrollment. Over 28 years, 148 developed SLE. Hypertension, diabetes, family history of CVD, and NSAID use were more common in the women with SLE and heart disease than in the SLE-free women with heart disease.

There were 20 cases of CVD (16 cases of heart disease and 4 strokes) among the women with SLE and 8,149 (6,254 cases of heart disease and 1,895 strokes) among the non-SLE group, said Dr. Hak, reporting on the investigation she conducted while at Brigham and Women's Hospital, Boston. Based on follow-up of 2,082 person-years for the women with SLE and 2,932,407 person-years for the SLE-free women, the incidence of CVD was 961 cases per 100,000 person-years for the SLE group and 271 per 100,000 person-years for the non-SLE group.

The age-adjusted relative risk for CVD was 2.75 in the SLE group, versus the non-SLE group. The multivariate-adjusted relative risk was 2.26 in the SLE women relative to the women without SLE after controlling for medication use, age, hypertension, race, diabetes, and serum lipid levels, reported Dr. Hak, now at Erasmus University Medical Centre, Rotterdam (the Netherlands).

The fact that the study enrolled women aged 30–55 years means that it excluded those with younger-onset SLE, in whom CVD may have been more common and severe, she noted at the annual meeting of the American College of Rheumatology. The findings also may have been affected by the fact that the cohort is overwhelmingly white.

Dr. Hak reported having no financial conflicts of interest.

SAN FRANCISCO — Systemic lupus erythematosus more than doubles a woman's relative risk for cardiovascular disease beyond the effect of traditional determinants, judging from the Nurses Health Study findings.

Earlier research reports have found a significantly greater than twofold increased risk for cardiovascular disease in women with lupus. However, those studies examined risk in lupus populations receiving care at tertiary care centers. The data from this study came from a study of the general population, according to investigator Dr. A. Elisabeth Hak.

The Nurses Health Study includes 121,700 women who enrolled in the prospective cohort study in 1976, when they were between 30 and 55 years old. They had no cardiovascular disease (CVD) or SLE at enrollment. Over 28 years, 148 developed SLE. Hypertension, diabetes, family history of CVD, and NSAID use were more common in the women with SLE and heart disease than in the SLE-free women with heart disease.

There were 20 cases of CVD (16 cases of heart disease and 4 strokes) among the women with SLE and 8,149 (6,254 cases of heart disease and 1,895 strokes) among the non-SLE group, said Dr. Hak, reporting on the investigation she conducted while at Brigham and Women's Hospital, Boston. Based on follow-up of 2,082 person-years for the women with SLE and 2,932,407 person-years for the SLE-free women, the incidence of CVD was 961 cases per 100,000 person-years for the SLE group and 271 per 100,000 person-years for the non-SLE group.

The age-adjusted relative risk for CVD was 2.75 in the SLE group, versus the non-SLE group. The multivariate-adjusted relative risk was 2.26 in the SLE women relative to the women without SLE after controlling for medication use, age, hypertension, race, diabetes, and serum lipid levels, reported Dr. Hak, now at Erasmus University Medical Centre, Rotterdam (the Netherlands).

The fact that the study enrolled women aged 30–55 years means that it excluded those with younger-onset SLE, in whom CVD may have been more common and severe, she noted at the annual meeting of the American College of Rheumatology. The findings also may have been affected by the fact that the cohort is overwhelmingly white.

Dr. Hak reported having no financial conflicts of interest.

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