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http://www.nytimes.com/2003/12/30/health/30RISK.html

VITAL SIGNS
At Risk: Tricky Lupus Goes for the Heart
By ERIC NAGOURNEY

Published: December 30, 2003


People who have lupus, an autoimmune disease, are at higher risk for heart
disease, even if they do not have the customary warning signs like high
blood pressure or high cholesterol, researchers have found.

The findings have implications not just for the treatment of lupus but for
understanding what causes plaque to build up along the walls of the coronary
arteries, bringing on atherosclerosis.

The study's lead author, Dr. Mary J. Roman of Weill Medical College of
Cornell, notes that many researchers believe that atherosclerosis occurs as
a result of inflammation. Lupus, which affects an estimated 1.5 million
people in the United States, damages the kidneys, skin and joints, and Dr.
Roman described it as "a concentrated dose of inflammation."

The researchers, who published their findings Dec. 18 in The New England
Journal of Medicine, compared 197 patients with lupus and 197 people who did
not have the disease but whose health was otherwise comparable. Lupus
patients were 140 percent more likely to have atherosclerosis, the research
showed. For lupus patients under 40, the risk was 480 percent higher.

Although established risk factors like hypertension and diabetes play a role
in heart disease among lupus patients, the study found that lupus itself can
be a cause.

As doctors have made gains in treating some other disorders related to
lupus, like kidney disease, atherosclerosis has become the leading cause of
death for lupus patients, Dr. Roman said.

The study suggests that doctors treating people for lupus should consider
being more aggressive about treating atherosclerosis.
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