Perfil de risco cardiovascular numa população portuguesa de doentes com LES

Duarte, C; Couto, M; Vaz, C; Inês, L; Malcata, AB

http://hdl.handle.net/10400.4/630

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Abstract(s)

Systemic Lupus Erythematosus is associated with an increased risk of atherosclerosis and cardiovascular events, as compared to the general population. Objective: To evaluate the prevalence of «traditional» cardiovascular risk factors in Portuguese SLE patients and to estimate the associated risk of cardiovascular events. To evaluate the needs for optimization of prophylactic measures to prevent cardiovascular events in these patients. Material and Methods: Consecutive SLE patients followed in the Coimbra Lupus Cohort were included. Traditional cardiovascular risk factors were evaluated and risk factors associated to the disease (renal disease, anti-phospholipid antibodies, therapy) were evaluated. The 10-year cardiovascular risk was estimated using the Framingham model. Institution or optimization of therapeutic measures to control cardiovascular risk factors was evaluated according to published preliminary guidelines. Results: 102 SLE patients were included (female: 89.2%, mean age= 39.7 years old, mean disease duration=8.9 years). 40.5% are overweighted, obesity in 9.9%. 72.5% have sedentary lifestyle and 11.8% are currently smokers. 40.2% have arterial hypertension, 32% have dyslipidaemia. Metabolic syndrome was identified in 21% of patients. Of these patients, 79.05% present one or more cardiovascular classical risk factors. Were receiving more than 10 mg/day of prednisone, 23.6% of the patients. Estimated 10-year cardiovascular risk is higher than 1% in 24.7% patients. We estimate that 55.8% of patients might benefit from dietary changes, 79.4% from increase in physical activity, 55.9% could be on anti-hypertensive medication, 52,9% on lipid lowering therapy and 76.5% on low dose aspirin anti-platelet aggregation. Conclusion: Similar to findings in other academic centers, the majority of our patients have at least one modifiable, traditional cardiovascular risk factor which had not been treated adequately by standard guidelines and possibly even detected. These measures could greatly improve the long-term prognosis of SLE patients.