Vascular Stiffness in Women With Systemic Lupus Erythematosus

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Hypertension. 2001;37:1075.)

© 2001 American Heart Association, Inc.

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Scientific Contributions

Vascular Stiffness in Women With Systemic Lupus Erythematosus

Faith Selzer; Kim Sutton-Tyrrell; Shirley Fitzgerald; ;

Kuller; Manzi

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 Manzi, MD, MPH, Room S722, Biomedical Science Tower,

South Wing, 3500 Terrace St, Pittsburgh, PA 15261. E-mail sxm6+@...

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.