Coronary artery disease risk factors in the Johns Hopkins Lupus Cohort: prevalence, recognition by patients, and preventive practices

Medicine (Baltimore). 1992 Sep;71(5):291-302. doi: 10.1097/00005792-199209000-00004.

Abstract

Known risk factors for coronary artery disease are very common in the Hopkins Lupus Cohort, in spite of the fact that the average patients age is only 38.3 years. Three or more known risk factors were found in 53% of patients. Risk factors for CAD were common even in patients not on a regimen of prednisone therapy during their cohort follow-up. Hypercholesterolemia increased significantly with greater average prednisone dose. Despite the frequency of risk factors, patients' awareness of the risk of CAD was low, with only 16.9% of patients believing they were at high risk for developing CAD within 5 years. In general, awareness of individual risk factors was lower in black than in white patients with SLE. Preventive practices were most commonly addressed towards hypertension. Preventive practices directed against obesity, hypercholesterolemia, and smoking were underutilized. Whether these known risk factors are sufficient in and of themselves to explain the high frequency of CAD in the cohort (8%) or whether they are "enabling" factors acting upon endothelium damaged by immune-complex disease cannot be addressed by this study. However, both further investigation of these risk factors and attention to lifestyle and pharmacologic approaches to risk factor reduction are indicated by this study.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Baltimore / epidemiology
  • Cohort Studies
  • Continental Population Groups
  • Coronary Disease / epidemiology*
  • Coronary Disease / etiology
  • Coronary Disease / prevention & control
  • Cross-Sectional Studies
  • Female
  • Hospitals, University
  • Humans
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / epidemiology
  • Hypercholesterolemia / prevention & control
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertension / prevention & control
  • Incidence
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology
  • Obesity / prevention & control
  • Prednisone / therapeutic use
  • Prevalence
  • Risk Factors
  • Self Care
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking Prevention
  • Socioeconomic Factors
  • Surveys and Questionnaires

Substances

  • Prednisone