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    Traditional Cardiovascular Risk Factors and Systemic Lupus Erythematosus: A Bad Combination

    Systemic lupus erythematosus (SLE) affects multiple organs. The kidney is most commonly identified as a prominent target organ, but the standardized cardiovascular mortality for persons with SLE is actually 2.7 compared to controls.1,2 There is also a 1.3 to 2.3-fold higher risk for cerebrovascular disease and a 9.4 times higher incidence of peripheral vascular disease in the setting of SLE.1,2 There is room for aggressive cardiovascular risk factor intervention in this population prone to vascular disease.

    The following question, answers, and short discussion offer a brief review of a dangerous combination.

    1. Which of the following statements regarding cardiovascular risk factor modification in SLE are true? 

    A
    . Studies have demonstrated that hydroxychloroquine and aspirin may provide synergistic vascular protection when used in combination, thereby decreasing cardiovascular events in SLE.

    B. Statins cause a higher number of side effects in persons with SLE.

    C. Selected therapeutic agents (eg, rituximab and mycophenolate mofetil) can lower cardiovascular risk by reducing corticosteroid use.

    Answer and discussion on next page>

    Gregory W. Rutecki, MD
    Dr Rutecki is with the Cleveland Clinic National Consultation Service.

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