Management of Cardiovascular Risk Factors in Lupus Nephritis

Background: Patients with Lupus Nephritis (LN) show a higher prevalence of subclinical atherosclerosis and an elevated risk of cardiovascular disease (CVD) compared with healthy individuals. This study aims to examine the differences in the management of hypertension and hyperlipidemia to assess how these variations in treatment impact the prevalence of CVD in patients with LN. Methods: A retrospective data review of 128 patients over 14 years was performed. Cardiovascular risk factors were defined as the presence of at least one of the following: hyperlipidemia, diabetes, and hypertension. Treatment management was characterized by administering antihypertensive, antidiabetic, and lipid-lowering therapies. The rates of myocardial infarction, stroke, and new diagnoses of peripheral vascular disease were compared between patients with and without cardiovascular risk factors. Results: Patients with a cardiovascular risk factor (Group A) were older (Median age = 41 vs. 35 years, p = 0.038) and had a significantly longer duration of disease (Median = 65 vs. 50 months, p = 0.025) than patients without a risk factor (Group B). However, the gender distribution was similar in both groups (Male: 14% vs. 20%, p = 0.420). A higher number of patients in Group A received treatment (54.8% vs. 11.4%, p<0.001). The comparison between mean systolic blood pressure and laboratory data is shown in Table 1. Myocardial infarction and stroke were observed in 1.1% and 9.7% of patients in Group A, respectively, while no incidents were observed in Group B. Additionally, during management, 6.5% of patients in Group A were newly diagnosed with peripheral vascular disease, whereas no cases were diagnosed in Group B. However, none of these differences in the rate of CVD incidences were statistically significant. Conclusion: Our results suggest that despite effective management of cardiovascular risk factors in patients with LN, there was a higher rate of cardiovascular events. These findings might be due to the higher age and longer disease duration in our population, although more studies with larger sample sizes are needed to confirm these results. - Median/IQR (25%-75%) Group A (n=93) Group B (n=35) P value HbA1c (%) 5.65 (5.2-5.9) 5.3 (4.9-5.8) 0.087 LDL (mg/dL) 103 (82-128.6) 103 (82-128.6) 0.503 Systolic BP (mmHg) 117 (107.5-132.6) 115.17 (107.4-126) 0.168