Black Lupus Patients at Greater Risk of Strokes and Heart Disease

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Black patients with lupus have a threefold higher stroke risk and a 24-fold higher ischemic heart disease risk than other ethnic or racial groups with the condition, researchers say.

“Our study is important as it qualifies the risk predictors and timing of stroke and ischemic heart disease in Black people with lupus,” said Shivani Garg, M.D., assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health. Dr. Garg presented the findings at the annual meeting of the American College of Rheumatology on Friday.

Researchers have long known that the risk of cardiovascular disease was much higher among patients with lupus than in the general populace, and that Black people were more likely to develop lupus than White people. However, most previous research on lupus has focused on predominantly White patient cohorts, and Dr. Garg’s team wanted to learn more about the specific effects of lupus on the Black community.

To do this, the researchers gathered data from the Georgia Lupus Registry and selected 336 patients (87% female, 75% Black, mean age at diagnosis 40 years) from between 2002 and 2004. They cross-referenced this data with the Georgia Hospital Discharge Database and the National Death Index from 2000 to 2013. They determined which patients had suffered from strokes and ischemic heart disease-related hospitalizations and deaths based on hospital admission and death medical codes.

The researchers found that 38 strokes and 25 heart disease-related health events or deaths had occurred in this population during the timeframe under study. Black patients suffered 90% of the strokes and 96% of the heart-disease events. Seventy-eight percent of the strokes occurred in females. The mean age of patients at the time of the first stroke was 48 years.

In addition to examining potential racial disparities in complications, the researchers also studied potential clinical predictors of strokes and cardiovascular disease (CVD). They determined that patients suffering from discoid rashes at the time of lupus diagnosis had a five-fold higher risk of stroke, and patients with renal disorder at the time of lupus diagnosis had double the stroke risk. Patients with neurological (prior psychosis or seizure) and immunologic disorders (anti-DNA, anti-Sm, or antiphospholipid antibodies) were at higher risk of ischemic heart disease.

Dr. Garg expressed the hope that greater awareness of the heightened risks for Black patients with lupus will lead to more research and better health outcomes. “Such knowledge can help these patients and their providers to look for and diagnose for CVD events earlier and initiate discussions regarding CVD prevention to reduce their risk,” she said. “These timely interventions could help in reducing CVD disparities in lupus and reduce CVD-related morbidity and mortality.”

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REFERENCE

ABSTRACT: 0433. “Racial Disparities and New SLE-Specific Predictors of Stroke and Ischemic Heart Disease in Patients with Lupus.” The annual meeting of the American College of Rheumatology. 11:30 AM, Friday, Nov. 6, 2020