The risk of cardiovascular death of women with autoimmune diseases such as lupus, rheumatoid arthritis and systemic scleroderma is 50 % higher than that of men, warns a new study.
Posted at 10:11
Jean-Benoit Legault
Canadian press
It could therefore be time to add these diseases to the list of cardiovascular risk factors, in the same way as obesity, hypertension or smoking, commented Doctor François Simard, who is a clinical cardiologist at the Montreal Cardiology Institute.
“There are risk factors that are more frequent in women, such as inflammatory diseases,” he said. These patients should therefore probably be more detected, or have a little more integrative or holistic management of their cardiovascular risk factors in general. »»
The study authors analyzed data from the CDC Wonder database for more than 127,000 deaths related to cardiovascular diseases among more than 281,000 deaths associated with rheumatoid polyarthritis, lupus or systemic scleroderma.
The researchers measured trends and differences in death rates related to cardiovascular disease in men and women with the most common autoimmune diseases between 1999 and 2020.
The stroke (stroke) and coronary disease were the main causes of death for both sexes. The death rate of women was however higher than that of men.
In addition, women with an inflammatory autoimmune disease were two to three times more likely than men to succumb to an arrhythmia or cardiac arrest.
Inflammation, explained Doctor Simard, can damage the wall of the arteries and promote the formation of atherosclerosis plates. Inflammation will also make these plates more fragile, increasing the risk of myocardial or stroke infarction if they detach and form a clot.
It is a shame to note, he said, that the gap between men and women persists, despite the progress made by medicine over the past twenty years.
“I think it is a very clear reminder, unfortunately, from this bias that there has been in medical research since the start of cardiology,” he said.
Medical research has also been biased for decades in favor of men, added Doctor Simard. After having long held that the results of men were transposed to women, it was only relatively recently that it was found that this was not the case, and we try to have at least half of the participants in the studies.
“We still have jolts or consequences of the choices that have been made in the past,” deplored Doctor Simard.
But today, he continues, faced with the data of this study, we will have to ensure that the blood pressure of women is well controlled, or even to detect a possible diabetes or a cholesterol problem at home.
“It is sometimes something that we forget in care because we linger a lot to inflammatory disease,” concluded Doctor Simard. But this study shows us that what will harm their prognosis the most is cardiovascular health, so we should not lose sight of this aspect. »»
Previous studies had shown that patients with autoimmune diseases like these were more likely, after a heart attack, to die, to present heart failure or to undergo a second infarction, compared to people who did not have these diseases.
The prevention and control centers of the United States indicate that women are two to three times more likely than men to suffer from rheumatoid arthritis and nine times more at risk of lupus. Systemic scleroderma is also more widespread in women than in men.
The conclusions of this study were published by the medical newspaper Circulation : Cardiovascular Quality and Outcomes.
