Cardiac risk factor awareness and management in patients with systemic lupus erythematosus

Objective. To assess awareness and management of traditional cardiac risk factors (CRFs) in patients with systemic lupus erythematosus (SLE) and physicians. Methods. SLE patients (n = 110) completed a questionnaire concerning CRFs. Medical records were reviewed blinded to questionnaire results for the presence and management of 6 CRFs: hypertension, hypercholesterolemia, smoking, obesity, diabetes mellitus, and physical inactivity. Results. Subjects were predominantly female (97%), mean (+/-SD) age was 43.4 years (+/-11.8), mean SLE duration was 15.3 years (+/-7.2), and 51% had greater than or equal to2 CRFs by self report. Twenty-three percent had never had their cholesterol levels checked. Hypercholesterolemia was more frequently documented in the medical records than reported by the patient (33% versus 24%). Physical inactivity was more frequently self reported than documented (59% versus 23%). Rheumatologists and patients had low interrater reliability for the presence of hypercholesterolemia (kappa = 0.26) and physical inactivity (kappa = -0.02). More than half (58%) of CRFs were treated, and 21% of subjects with elevated cholesterol received a medication. Conclusion. Recognition, recording, and management of CRFs falls short given the significance of the problem.