People with the autoimmune disease lupus may develop carotid atherosclerosis (the buildup of fatty deposits in the arteries) at an accelerated rate and independently of many risk factors normally associated with cardiovascular disease, according to a new study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health. The work was reported in the December 18 issue of the "New England Journal of Medicine".

The study, carried out by Mary J Roman, MD, at Weill Medical College of Cornell University, Jane E Salmon, MD, at the Hospital for Special Surgery (NY), and their colleagues examined 197 people with lupus and the same number of matched controls. Risk factors for cardiovascular disease, including family history of heart disease, cholesterol levels, smoking and hypertension, were similar in both groups, but atherosclerosis, as evidenced by carotid ultrasound, was more prevalent in lupus patients. The scientists also found that people with lupus who had the disease longer, had more damage from the disease, and had used less of the immunosuppressive drug cyclophosphamide to treat it were more likely to develop fatty deposits in their arteries.

"Although we've known for some time that there is an association between lupus and premature heart attacks," said NIAMS director Stephen I Katz, MD, PhD "until now we haven't understood the reasons. This study gives us a basis to pursue intervention strategies for reducing cardiovascular risks."

Lupus (systemic lupus erythematosus) is a rheumatic disease that can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain. People who have lupus may have many different symptoms, but some of the most common ones include extreme fatigue, painful or swollen joints (arthritis), unexplained fever, skin rashes and kidney problems. Many more women than men have lupus. It is three times more common in African American women than in Caucasian women and is also more common in women of Hispanic, Asian and Native American descent.

The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases.