March, 2019

New results partially funded by the Lupus Research Alliance found that people with systemic lupus erythematosus have almost double the risk for a dangerous condition, resistant hypertension (RHTN) than those without the disease. RHTN is defined as blood pressure that either remains high despite treatment with three anti-hypertensive medications or is controlled only with four or more medications.  Investigators concluded that it is important for healthcare providers to look for resistant hypertension when treating people with SLE.

Previous research has shown that people with lupus are at five times greater risk for heart damage than healthy individuals; but recent studies suggest that the reasons why may go beyond traditional cardiovascular risk factors and indicators of inflammation. With his grant from the LRA, Dr. Michael Stein worked with lead investigator Dr. Cecilia Chung and other researchers at Vanderbilt University Medical Center to explore RHTN as an important risk factor to consider.

Study authors point out that while RHTN is relatively rare in the general population, it is known to increase the rate of coronary artery disease by 44%, stroke by 57% and death by 30%.  Their study aimed to provide much-needed information about RHTN among people with lupus.

The Vanderbilt researchers compared the medical health records over a period of nearly 30 years for 1,044 SLE patients with 5,241 others which included people who were healthy, as well as those with a range of non-lupus related chronic medical issues.

Authors concluded that the risk for and prevalence of RHTN is higher among people with lupus than those who do not have lupus.  They also found that among those with lupus the risk for developing RHTN is greater for those who are black, older age, male and/or have kidney disease. They emphasized that since RHTN increases the risk of death, it should be paid close attention by treating healthcare providers.

“High blood pressure is a common problem for patients with lupus,” commented Dr. Stein.  Now, in work supported in part by the Lupus Research Alliance we found that resistant hypertension is twice as common in people with lupus compared to those without lupus. The study emphasizes the importance of diagnosing and treating high blood pressure in people with lupus and shows that for many patients blood pressure can be difficult to control.”

The paper was published in Arthritis Care & Research.