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African–American and Hispanic ethnicities, renal involvement and obesity predispose to hypertension in systemic lupus erythematosus: results from LUMINA, a multiethnic cohort (LUMINAXLV)
  1. Sumapa Chaiamnuay1,
  2. Ana M Bertoli1,
  3. Jeffrey M Roseman1,
  4. Gerald McGwin1,
  5. Mandar Apte1,
  6. Sergio Durán1,
  7. Luis M Vilá2,
  8. John D Reveille3,
  9. Graciela S Alarcón1
  1. 1University of Alabama at Birmingham, Birmingham, Alabama, USA
  2. 2The University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
  3. 3The University of Texas Health Science Center at Houston, Houston, Texas, USA
  1. Correspondence to:
    Dr G S Alarcón
    830 Faculty Office Tower, 510 20th Street South, Birmingham, Alabama 35294–3408, USA; graciela.alarcon{at}ccc.uab.edu

Abstract

Objective: To examine the predictors of the occurrence of hypertension in a large multiethnic US cohort.

Patients and methods: There were 614 patients with systemic lupus erythematoses (SLE; ⩾4 American College of Rheumatology revised criteria) with ⩽5 years of disease duration at entry into the cohort (T0) and of Hispanic (Texan or Puerto Rican), African–American or Caucasian ethnicity. T0 variables were compared between patients who did and did not develop hypertension (blood pressure ⩾140/90 mm Hg on at least two occasions and/or the use of antihypertensive drugs) after T0. Significant and clinically relevant variables were then examined by a stepwise logistic regression model.

Results: A total of 379 patients without hypertension at T0 were included (patients who developed hypertension prior to SLE diagnosis (n = 126) or before T0 (n = 109) were excluded). Predictors of hypertension were African–American and Texan–Hispanic ethnicities, renal involvement and a higher body mass index.

Conclusions: Traditional cardiovascular risk factors, disease-related factors and ethnicity play a role in the occurrence of hypertension in patients with SLE. Controlling renal involvement and optimising body weight may prevent the occurrence of hypertension.

  • ACR, American College of Rheumatology
  • aPL, antiphospholipid
  • BMI, body mass index
  • ds DNA, double stranded DNA
  • LDL, low-density lipoprotein
  • LUMINA, Lupus in Minorities: Nature vs Nurture
  • SDI, Systemic Lupus International Collaborating Clinics Damage Index
  • SLAM-R, Systemic Lupus Activity Measure-Revised
  • SLE, systemic lupus erythematosus

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Footnotes

  • Published Online First 15 November 2006

  • Funding: Supported by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases #R01-AR42503, General Clinical Research Centers #M01-rr02558 (UTH-HSC) and M01-RR00032 (UAB), the National Center for Research Resources (NCRR/NIH) RCMI clinical research infrastructure initiative (RCRII) award 1p20RR11126 (UPR-MSC), the Mary Kirkland Scholars Award Program (UABP) and the Stellar Program (Supporting Training Efforts in Lupus for Latino American Rheumatologists) funded by Rheuminations (UAB).

  • Competing interests: None declared.

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