Patients with systemic lupus erythematosus (SLE) who attended a voluntary counseling program on prevention of cardiovascular disease (CVD) had reduced risk factors related to CVD after 3 years, according to recent research published in Arthritis Care & Research.

“Our program evaluation, investigating the effect of a free CVD prevention counseling program on the prevalence of CVD risk factors in SLE patients, demonstrated that patients with baseline abnormal values had significant improvements in their mean systolic blood pressure, blood glucose, [high-density lipoprotein] and [triglyceride] levels, diet, and physical activity during the 3-year follow-up,” Cécile Yelnik, MD, from the University of Lille in Lille, France, and colleagues wrote in their study. 

Dr Yelnik and colleagues evaluated 121 patients between March 2009 and December 2014 who underwent a 2-phased CVD prevention counseling program. Of these patients, 82 (68%) had an abnormal cholesterol profile, 77 (64%) had a body mass index ≥25 kg/m2, 50 patients (41%) had abnormal blood pressure, and 7 patients (6%) have an abnormal blood glucose level. There were 100 patients (83%) at baseline with poor diet and 95 patients (79%) with poor physical activity at baseline.

“The assessment phase included the evaluation of blood pressure, blood glucose, cholesterol profile, body mass index (BMI), smoking, lifestyle habits (diet and exercise), [antiphospholipid antibody] profile, and medications,” Dr Yelnik and colleagues wrote. “The education phase for patients, independent of the CVD risk level, included detailed discussion of the above risk factors, as well as CVD and thrombosis prevention strategies. At the end of each visit, patients received tailored lifestyle recommendations and a written summary report, and were referred to a registered dietitian as needed based on preset criteria.”


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High Yield Data Summary

  • Researchers found decreased prevalence of abnormal blood pressure (odds ratio [OR], 0.94), improved mean systolic blood pressure (−6.12±2.16 mm Hg; P <.05), decreased abnormal cholesterol (OR, 0.90), and improved high-density lipoprotein levels (+5.4±0.36 mg/dL; P <.0001) and triglyceride levels (−12.6±5.40 mg/dL; P <.05) compared at baseline.
  • Patients with poor activity and poor diet at baseline also saw significant improvements after 3-year follow-up.

The researchers found significantly decreased prevalence of abnormal blood pressure (odds ratio [OR], 0.94; 95% CI, 0.92-0.96; P <.0001), mean systolic blood pressure significantly improved (−6.12±2.16 mm Hg; P <.05), abnormal cholesterol significantly decreased (OR, 0.90; 95% CI, 0.92–0.96), and high-density lipoprotein levels (+5.4±0.36 mg/dL; P <.0001) and triglyceride levels (−12.6±5.40 mg/dL; P <.05) significantly improved among patients with abnormal measurements at baseline. Patients with poor activity and poor diet at baseline also saw significant improvements after 3-year follow-up. 

Summary and Clinical Applicability 

“[O]ur data suggest that a CVD prevention counseling program decreases the prevalence of CVD risk factors in SLE patients,” Dr Yelnik and colleagues wrote in their study. “Although we believe that CVD prevention counseling should be incorporated into routine lupus care, long-term follow-up of larger SLE cohorts will determine if the counseling decreases the incidence of CVD.”

Limitations 

The researchers noted poor follow-up at 3 years from baseline, lack of data on the number of patients referred to counseling, lack of controlled intervention, lack of data on premenopausal status and lupus disease activity, self-reported data, moderate point estimates translating to limited clinical significance, low prevalence of CVD risk factors, and lack of study design to generate estimates of benefit to patients undergoing CVD prevention counseling as limitations in this study.

Disclosures

The researchers received support from the New York Community Trust and Clinical and Translational Science Center at Weill Cornell Medicine.

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Reference

Yelnik CM, Richey M, Haiduc V, et al. Cardiovascular disease prevention counseling program for systemic lupus erythematosus patients. Arthritis Care Res. 2017;69(8):1209-1216.