Vascular Elasticity of Systemic Lupus Erythematosus Patients Is Associated with Steroids and Hydroxychloroquine Treatment

Authors: TANAY, AMIR¹; LEIBOVITZ, EYAL²; FRAYMAN, ANGELA²; ZIMLICHMAN, REUVEN³; GAVISH, DOV²

Source: Annals of the New York Academy of Sciences, Volume 1108, Number 1, June 2007 , pp. 24-34(11)

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Abstract:

We studied the large and small artery elasticity (AE) and systemicvascular resistance (SVR) of systemic lupus erythematosus (SLE) patients according to treatment profile. Forty-one SLE patients (90% female, mean age 48.7 ± 2.4 years) were compared to 96 healthy controls. The large and small AE and the SVR were derived from radial artery waveforms (model CR-2000, HDI Inc.). Patients were categorized into groups according to treatment: steroid (12), hydroxychloroquine (HCQ) (9), steroid+HCQ (16), and no-steroids-no-HCQ (4). The steroid group had reduced large AE and increased SVR as compared to the HCQ group (8.3 mmHg·mL·10 and 18.4 dyne·sec·10⁻³ versus 13.7 and 14.4, respectively). Mean large AE and the SVR of the HCQ group was similar to that of the controls (11.8 mmHg·mL·10 and 14.5 dyne·sec·10⁻³, respectively). Mean large AE and SVR of the steroid+HCQ group were better than the steroid group (10.4 mmHg·mL·10 and 16.0 dyne·sec·10⁻³). Patients that received steroids had higher rates of hypertension (36%) and diabetes (11%) compared to rest of the patients (15% and 0%, respectively). Small AE, blood pressure, CRP, and SLEDAI were similar between the groups. Among SLE patients, steroid treatment was associated with the highest degree of vascular damage, and HCQ was associated with the lowest degree of vascular damage. It is possible that the steroids are responsible in part to the increased large-vessel manifestations observed in these patients, and that HCQ might have a protective effect on the vessel wall.

Keywords: SLE; arterial elasticity; atherosclerosis; steroids; hydroxychloroquine

Document Type: Research article

DOI: http://dx.doi.org/10.1196/annals.1422.003

Affiliations: 1: Rheumatology Unit, Wolfson Medical Center, Holon, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 2: Department of Medicine A and F, Wolfson Medical Center, Holon, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 3: Bruner Institute of Cardiovascular Research, Wolfson Medical Center, Holon, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Publication date: 2007-06-01

Vascular Elasticity of Systemic Lupus Erythematosus Patients Is Associated with Steroids and Hydroxychloroquine Treatment

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