Prevalence and target attainment of traditional cardiovascular risk factors in patients with systemic lupus erythematosus: a cross-sectional study including 3401 individuals from 24 countries

Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disorder affecting mostly young women. Patients with SLE have a two-to-ten-fold higher risk for cardiovascular events compared with the general population,1 and cardiovascular disease, along with infections, represents a leading cause of mortality in these patients.2 Several disease-related risk factors have been associated with high risk of cardiovascular disease in SLE, including disease duration and activity, renal involvement, treatment-associated factors (eg, prolonged exposure to glucocorticoids), and antiphospholipid antibodies.3 The presence of persistently positive antiphospholipid antibodies in association with arterial or venous thrombosis, characterised as antiphospholipid syndrome, has been linked to high cardiovascular-related morbidity risk in patients with SLE.4 Increasing evidence has also shown an independent association between traditional cardiovascular risk factors and cardiovascular events in patients with SLE. The 2022 European Alliance of Associations for Rheumatology (EULAR) recommendations for the management of cardiovascular risk in rheumatic and musculoskeletal diseases including SLE and antiphospholipid syndrome, highlighted the importance strict control of traditional cardiovascular risk factors in these patients.5 For the management of most traditional cardiovascular risk factors in SLE, the implementation of the established guidelines for the general population was recommended, emphasising also the importance of a blood pressure target of lower than 130/80 mm Hg.5 However, reports originating mostly from single-centre studies, have shown that cardiovascular risk factors are often unrecognised and undertreated in patients with SLE.6