Researchers say high blood pressure control may improve outcomes for lupus patients.

High blood pressure and other factors, such as steroid medication, may worsen lupus, according to research presented at the American College of Rheumatology October annual meeting.

Lupus, or Systemic Lupus Erythematosus (SLE), is a chronic inflammatory disease that affects an estimated 160,000 U.S. adults and many more women than men. The disease occurs when the immune system attacks its tissues, causing swelling, pain, and damage. It can affect the joints, skin, kidneys, lungs, nervous system, and other organs. Symptoms include fatigue, joint pain, fever, and a lupus rash. Early damage is an important distinguishable factor that predicts future damage and mortality.

Ian Bruce, MD, Manchester University rheumatology professor, and colleagues set out to examine the rate of damage buildup in early SLE, factors that determine the progression of damage, and the relationship between damage and survival. They found a number of modifiable risk factors for damage, namely disease activity, hypertension, steroid use and a protective effect of antimalarial use.

The researchers followed 1,722 patients with lupus between 2000 and 2011. The average age at cohort entry and number of visits was 35 years and 4.25 respectively. At the start of the study, 600 (34.8 percent) of patients had at least one item of damage rising to 51.1 percent by 6 years follow-up. They analyzed 1,502 patients, including 1,337 (89 percent) females for SDI change over time. Patients with initial damage were more likely to increase their SDI at each follow-up visit.

Besides high blood pressure and steroid use, other risk factors other factors were older age, being of African descent within the U.S. and having higher lupus damage at the beginning of the study. They also found that an increase in pre-existing damage was reduced in patients taking anti-malarial drugs.

Bruce said that an integrated intervention strategy to address these factors “may improve long-term outcomes in SLE patients.” As a next step, he says further studies are needed to test whether controlling blood pressure and reducing steroid use will help lupus patients.

The American College of Rheumatology is a non-profit organization that represents over 8,500 rheumatologists and rheumatology health professionals including physicians, health professionals, and scientists. It aims to advance rheumatology through programs of education, research, advocacy and practice support that foster excellence in the care of people with arthritis and rheumatic and musculoskeletal diseases.

 

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