Appropriate cardiovascular disease risk assessment in systemic lupus erythematosus may be lacking in rheumatology practice

作者：Esmaeilbeigi Faranak; Pope Janet E.^*

来源：Clinical and Experimental Rheumatology, 2018, 36(4): 526-532.

• systemic lupus erythematosus
• cardiovascular risk
• rheumatologist opinions
• guidelines
• survey
• quality indicators
• risk stratification
• antiphospholipid antibody syndrome

Objective
To determine practices regarding cardiovascular (CV) risk assessment in systemic lupus erythematosus (SLE) amongst rheumatologists.
Methods
A questionnaire assessing preventative strategies, risk assessment, and beliefs regarding SLE and CV disease was sent electronically to 425 members of the Canadian Rheumatology Association. Questions were based on published recommendations for CV risk management. Responses were stratified based practitioner's characteristics.
Results
Ninety-nine rheumatologists and trainees responded (22% response rate). Nearly all (91%) believed that SLE is a major CV risk factor, and 68% felt rheumatologists should assess CV risk; whereas 42% were not comfortable with guidelines, 97% felt that family physicians are not aware of the CV risk in SLE but 64% did not routinely inform them in their correspondence. For SLE patients followed: 15% did not check blood pressure at every visit, 32% did not order cholesterol and 34% did not screen for diabetes irrespective of the presence of additional risk factors. Half (54%) would stratify SLE patients as intermediate or high risk when deciding on lipid lowering treatment. For SLE, 45% recommended a target blood pressure of 140/90 and 55% recommended 130/80 as the target.
Conclusion
CV risk assessment and preventative measures were inconsistent when rheumatologists monitored SLE patients, indicating a care gap. Improved communication between rheumatologists and family physicians with respect to elevated CVD risk in SLE is needed.

• 出版日期2018-8