Objective:
Increased arterial stiffness has been reported in subjects with systemic lupus erythematosus (SLE) compared with healthy controls, and this association is partially reverted by immunosuppressive treatment. In SLE, indexes of organ damage are related to a poor clinical status and worse prognosis independently from the activity of the disease. Data are controversial about the association between organ damage and arterial stiffness in SLE.
Design and method:
40 subjects with positive history of SLE (mean age 45 ± 12 years, 90% women) and a median disease duration of 12 years (IQR 5–19), underwent assessment of carotid-femoral pulse wave velocity (cf-PWV) by means of applanation tonometry (SphygmoCor). A comprehensive clinical, metabolic and immunological assessment was performed. Irreversible organ damage, not related to active inflammation, was assessed through the Systemic Lupus International Collaborating Clinics (SLICC) damage index. The relationship between cf-PWV and SLICC index was investigated with univariate and multivariate models.
Results:
Mean blood pressure was 128/75 ± 16/10 mmHg. 9 subjects (23%) were on anti-hypertensive treatment, 4 (10%) had had previous cardiovascular events, 17 (42%) subjects were treated with steroids, 29 (71%) with hydroxychloroquine and 15 (37%) with other immunosuppressants. Median SLICC index was 2 (IQR 1–3) and average cf-PWV was 7.5 ± 1.9 m/s. cf-PWV significantly increased across SLICC damage index categories (F = 3.141, p < 0.019). The association between cf-PVW and SLICC index persisted after adjustment for age, sex, mean arterial pressure, height, heart rate, disease duration, anti-hypertensive treatment, number of drugs for SLE therapy, C-reactive protein and previous cardiovascular events (p = 0.031).
Conclusions:
In a cohort of subjects with SLE under active treatment, SLICC damage index had a significant independent association with cf-PWV. Further studies are needed to explore the role of arterial stiffness as a predictor of disease-related organ damage in SLE.
