(Hypertension. 2001;37:1075.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Vascular Stiffness in Women With Systemic Lupus Erythematosus
From the University of Pittsburgh Graduate School of Public Health (F.S., K.S.T., L.K.), the University of Pittsburgh School of Health and Rehabilitation Sciences and VA Medial Center, Human Engineering Research Laboratory (S.F.), and the University of Pittsburgh School of Medicine and Graduate School of Public Health (S.M.), Pittsburgh, Pa; and the University of Vermont College of Medicine (R.T.), Burlington, VT.
Correspondence to Susan Manzi, MD, MPH, Room S722, Biomedical Science Tower, South Wing, 3500 Terrace St, Pittsburgh, PA 15261. E-mail sxm6+{at}pitt.edu
Abstract—Large-vessel manifestations of systemic lupus erythematosus (SLE), a multisystem disease characterized by disturbances in the immune system, include higher than expected rates of hypertension and cardiovascular disease. Reductions in the elasticity of central arteries may act as a marker of early changes that predispose to the development of major vascular disease. This study evaluated risk factors associated with aortic stiffness measured by pulse wave velocity (PWV) in women with SLE. We expected SLE-specific factors, especially variables indicative of inflammation and active disease, to be associated with increasing PWV. The study population included 220 women currently enrolled in the Pittsburgh Lupus Registry. All risk factor data were collected on the day of the ultrasound examinations. PWV waveforms were collected from the right carotid and femoral arteries by Doppler probes. The mean age of the women was 45.5±10.8 years, the median SLE disease duration approximated 9 years, and the mean PWV was 6.1±1.7 m/s. Multiple regression models were stratified by menopausal status. Among postmenopausal women, PWV risk factors were primarily traditional factors and included age, systolic blood pressure, family history of vascular disease, carotid plaque, creatinine, obesity, glucose, white cell count, and cumulative SLE organ damage. Among premenopausal women, PWV risk factors consisted of a mix of SLE-related and traditional variables and included higher C3 levels, presence of ds-DNA antibodies, nonuse of hydroxychloroquine, lower leukocyte count, higher mean arterial pressure, and carotid plaque. SLE-specific variables appeared to be associated with increases in aortic PWV, indicating central artery stiffening. This was seen most clearly among premenopausal women. This finding may partially explain the higher rates of cardiovascular disease and hypertension observed in young women with SLE.
Key Words: aorta • lupus • women • immune system • cardiovascular disease
This article has been cited by other articles:
 |
|
 |
|
  M. Pertovaara, M. Kahonen, M. Juonala, T. Laitinen, L. Taittonen, T. Lehtimaki, J. S. A. Viikari, O. T. Raitakari, and M. Hurme Autoimmunity and atherosclerosis: the presence of antinuclear antibodies is associated with decreased carotid elasticity in young women. The Cardiovascular Risk in Young Finns Study Rheumatology, December 1, 2009; 48(12): 1553 - 1556. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Cecelja and P. Chowienczyk Dissociation of Aortic Pulse Wave Velocity With Risk Factors for Cardiovascular Disease Other Than Hypertension: A Systematic Review Hypertension, December 1, 2009; 54(6): 1328 - 1336. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. SABIO, J. VARGAS-HITOS, M. ZAMORA-PASADAS, J. D. MEDIAVILLA, N. NAVARRETE, A. RAMIREZ, C. HIDALGO-TENORIO, L. JAIMEZ, J. MARTIN, J. JIMENEZ-ALONSO, et al. Metabolic Syndrome Is Associated with Increased Arterial Stiffness and Biomarkers of Subclinical Atherosclerosis in Patients with Systemic Lupus Erythematosus J Rheumatol, October 1, 2009; 36(10): 2204 - 2211. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Recio-Mayoral, J. C. Mason, J. C. Kaski, M. B. Rubens, O. A. Harari, and P. G. Camici Chronic inflammation and coronary microvascular dysfunction in patients without risk factors for coronary artery disease Eur. Heart J., August 1, 2009; 30(15): 1837 - 1843. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. E Bolton, J. R Cockcroft, R. Sabit, M. Munnery, C. M McEniery, I. B Wilkinson, S. Ebrahim, J. E Gallacher, D. J Shale, and Y. Ben-Shlomo Lung function in mid-life compared with later life is a stronger predictor of arterial stiffness in men: The Caerphilly Prospective Study Int. J. Epidemiol., June 1, 2009; 38(3): 867 - 876. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Cypiene, M Kovaite, A Venalis, J Dadoniene, R Rugiene, Z Petrulioniene, L Ryliskyte, and A Laucevicius Arterial wall dysfunction in systemic lupus erythematosus Lupus, May 1, 2009; 18(6): 522 - 529. [Abstract] [PDF]
|
|
|
|
 |
|
 M. J. Ryan Young Investigator Award Lecture of the APS Water and Electrolyte Homeostasis Section, 2008: The pathophysiology of hypertension in systemic lupus erythematosus Am J Physiol Regulatory Integrative Comp Physiol, April 1, 2009; 296(4): R1258 - R1267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F Cacciapaglia, E. Zardi, G Coppolino, F Buzzulini, D Margiotta, L Arcarese, M Vadacca, A Amoroso, and A Afeltra Stiffness parameters, intima-media thickness and early atherosclerosis in systemic lupus erythematosus patients Lupus, March 1, 2009; 18(3): 249 - 256. [Abstract] [PDF]
|
|
|
|
|
|
J. Sabio, M Zamora-Pasadas, J Jimenez-Jaimez, F Albadalejo, J Vargas-Hitos, M. Rodriguez del Aguila, C Hidalgo-Tenorio, M. Gonzalez-Gay, and J. Alonso Metabolic syndrome in patients with systemic lupus erythematosus from Southern Spain Lupus, September 1, 2008; 17(9): 849 - 859. [Abstract] [PDF]
|
|
|
|
|
|
R. Telles, C. Lanna, G. Ferreira, A. Souza, T. Navarro, and A. Ribeiro Carotid atherosclerotic alterations in systemic lupus erythematosus patients treated at a Brazilian university setting Lupus, February 1, 2008; 17(2): 105 - 113. [Abstract] [PDF]
|
|
|
|
 |
|
 M. J. Roman and J. E. Salmon Cardiovascular Manifestations of Rheumatologic Diseases Circulation, November 13, 2007; 116(20): 2346 - 2355. [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. M. Wasko, H. B. Hubert, V. B. Lingala, J. R. Elliott, M. E. Luggen, J. F. Fries, and M. M. Ward Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis JAMA, July 11, 2007; 298(2): 187 - 193. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Chaiamnuay, A. M Bertoli, J. M Roseman, G. McGwin, M. Apte, S. Duran, L. M Vila, J. D Reveille, and G. S Alarcon African-American and Hispanic ethnicities, renal involvement and obesity predispose to hypertension in systemic lupus erythematosus: results from LUMINA, a multiethnic cohort (LUMINAXLV) Ann Rheum Dis, May 1, 2007; 66(5): 618 - 622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Ryan and G. R. McLemore Jr. Hypertension and impaired vascular function in a female mouse model of systemic lupus erythematosus Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2007; 292(2): R736 - R742. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Laurent, J. Cockcroft, L. Van Bortel, P. Boutouyrie, C. Giannattasio, D. Hayoz, B. Pannier, C. Vlachopoulos, I. Wilkinson, H. Struijker-Boudier, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications Eur. Heart J., November 1, 2006; 27(21): 2588 - 2605. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N Bjarnegard, C Bengtsson, J Brodszki, G Sturfelt, O Nived, and T Lanne Increased aortic pulse wave velocity in middle aged women with systemic lupus erythematosus Lupus, October 1, 2006; 15(10): 644 - 650. [Abstract] [PDF]
|
|
|
|
|
|
T. K. Tso, W.-N. Huang, H.-Y. Huang, and C.-K. Chang Relationship of plasma interleukin-18 concentrations to traditional and non-traditional cardiovascular risk factors in patients with systemic lupus erythematosus Rheumatology, September 1, 2006; 45(9): 1148 - 1153. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Ng, F. Fantin, C. Ng, F. Dockery, R. Schiff, K. A. Davies, C. Rajkumar, and J. C. Mason Takayasu's arteritis: a cause of prolonged arterial stiffness Rheumatology, June 1, 2006; 45(6): 741 - 745. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. C. Hall and N. Dalbeth Disease modification and cardiovascular risk reduction: two sides of the same coin? Rheumatology, December 1, 2005; 44(12): 1473 - 1482. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T K Tso, W-N Huang, H-Y Huang, and C-K Chang Association of brachial-ankle pulse wave velocity with cardiovascular risk factors in systemic lupus erythematosus Lupus, November 1, 2005; 14(11): 878 - 883. [Abstract] [PDF]
|
|
|
|
|
|
M. J. Roman, R. B. Devereux, J. E. Schwartz, M. D. Lockshin, S. A. Paget, A. Davis, M. K. Crow, L. Sammaritano, D. M. Levine, B.-A. Shankar, et al. Arterial Stiffness in Chronic Inflammatory Diseases Hypertension, July 1, 2005; 46(1): 194 - 199. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Buyon, M. A. Petri, M. Y. Kim, K. C. Kalunian, J. Grossman, B. H. Hahn, J. T. Merrill, L. Sammaritano, M. Lockshin, G. S. Alarcon, et al. The Effect of Combined Estrogen and Progesterone Hormone Replacement Therapy on Disease Activity in Systemic Lupus Erythematosus: A Randomized Trial Ann Intern Med, June 21, 2005; 142(12_Part_1): 953 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Diamant, H. J. Lamb, M. A. van de Ree, E. L. Endert, Y. Groeneveld, M. L. Bots, P. J. Kostense, and J. K. Radder The Association between Abdominal Visceral Fat and Carotid Stiffness Is Mediated by Circulating Inflammatory Markers in Uncomplicated Type 2 Diabetes J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1495 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Brodszki, C Bengtsson, T Lanne, O Nived, G Sturfelt, and K Marsal Abnormal mechanical properties of larger arteries in postmenopausal women with systemic lupus erythematosus Lupus, December 1, 2004; 13(12): 917 - 923. [Abstract] [PDF]
|
|
|
|
|
|
S R Johnson, P J Harvey, J S Floras, M Iwanochko, D Ibanez, D D Gladman, and M Urowitz Impaired brachial artery endothelium dependent flow mediated dilation in systemic lupus erythematosus: preliminary observations Lupus, August 1, 2004; 13(8): 590 - 593. [Abstract] [PDF]
|
|
|
|
|
|
C. Gorman and D. Isenberg Atherosclerosis and lupus Rheumatology, August 1, 2004; 43(8): 943 - 945. [Full Text] [PDF]
|
|
|
|
|
|
S. W. Watts C3 or Not C3: That Is the Question Hypertension, July 1, 2004; 44(1): 25 - 26. [Full Text] [PDF]
|
|
|
|
|
|
A Theodoridou, L Bento, D P D'Cruz, M A Khamashta, and G R V Hughes Prevalence and associations of an abnormal ankle-brachial index in systemic lupus erythematosus: a pilot study Ann Rheum Dis, December 1, 2003; 62(12): 1199 - 1203. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P. Wildman, R. H. Mackey, A. Bostom, T. Thompson, and K. Sutton-Tyrrell Measures of Obesity Are Associated With Vascular Stiffness in Young and Older Adults Hypertension, October 1, 2003; 42(4): 468 - 473. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K Manger, M Kusus, C Forster, D Ropers, W G Daniel, J R Kalden, S Achenbach, and B Manger Factors associated with coronary artery calcification in young female patients with SLE Ann Rheum Dis, September 1, 2003; 62(9): 846 - 850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y Molad, A Gorshtein, A J Wysenbeek, D Guedj, R Majadla, A Weinberger, and M Amit-Vazina Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort{ Lupus, June 1, 2002; 11(6): 356 - 361. [Abstract] [PDF]
|
|
|
|
 |
|
 M. ZUREIK, A. BENETOS, C. NEUKIRCH, D. COURBON, K. BEAN, F. THOMAS, and P. DUCIMETIERE Reduced Pulmonary Function Is Associated with Central Arterial Stiffness in Men Am. J. Respir. Crit. Care Med., December 15, 2001; 164(12): 2181 - 2185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Sutton-Tyrrell, A. Newman, E. M. Simonsick, R. Havlik, M. Pahor, E. Lakatta, H. Spurgeon, and P. Vaitkevicius Aortic Stiffness Is Associated With Visceral Adiposity in Older Adults Enrolled in the Study of Health, Aging, and Body Composition Hypertension, September 1, 2001; 38(3): 429 - 433. [Abstract] [Full Text] [PDF]
|
|