Hypertension is associated with global and renal damage accrual in patients with systemic lupus erythematosus. Data from the Almenara Lupus Cohort

Abstract

Objectives

To determine the association between the occurrence of hypertension and damage accrual in patients with systemic lupus erythematosus (SLE).

Materials and methods

From January 2012 to January 2020, we evaluated 314 SLE patients, all members of the Almenara Lupus Cohort. We applied the American College of Cardiology/American Heart Association (ACC/AHA) guidelines to define hypertension, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) to determine organ damage, and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) to assess disease activity. We performed univariable and multivariable analysis using generalized estimating equations, adjusting for potential confounders (demographic factors, disease-related factors and treatment).

Results

314 patients and 1695 visits were included; 93% of the patients were women. Their mean disease duration was of 6.8 years (SD: 6.4), and their age at diagnosis of 35.7 (SD: 13.4) years. Baseline damage was 0.8 (SD: 1.2) at the first visit, increasing by 0.15 points at the subsequent follow-up visit (SD: 0.46). The prevalence of hypertension in these patients was 56.4% at least once during their follow-up. In the multivariable analysis, hypertension remained associated with damage accrual (IRR: 1.645, 95% CI: 1.187–2.280, p = 0.003) after adjusting for confounders. In the analyses performed per domain, hypertension was associated with renal damage in the multivariable model (OR: 4.331, 95% CI 1.547–12.126, p = 0.005).

Conclusion

Hypertension was associated with subsequent greater damage in our SLE patients. Thus, providers involved on the care of these patients should monitor their blood pressure at all clinic visits.