This week, Bobbi Conner talks with Dr. Kathleen McKinnon about lupus and increased cardiovascular risk. Dr. McKinnon is a rheumatologist and Director of the Center for Vasculitis Care and Research at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Individuals with an autoimmune disorder called lupus often need extra screening and care to manage an increased risk for cardiovascular disease. Doctor Kathleen McKinnon is here to provide the details. Doctor McKinnon is a rheumatologist and Director of the Center for Vasculitis Care and Research at MUSC. Doctor McKinnon, tell us about lupus.
Dr. McKinnon: Lupus is a disease where your immune system identifies your body as foreign, and it attacks different parts of your body. It can be something like the skin or joints, but can even involve attack of the internal organs.
Conner: And how is lupus typically diagnosed?
Dr. McKinnon: Patients with lupus oftentimes have a delay to a diagnosis because the symptoms and signs can be intermittent, and the symptoms and signs often at the beginning, can be nonspecific. Patients may feel fatigued. They may have unexplained fevers. They may have joint pain that comes and goes. So oftentimes patients have symptoms for a period of time, see their primary care doctor who refers them to a rheumatologist, where further evaluations, including blood tests, are done to help establish this diagnosis.
Conner: And I understand that lupus can pose hidden risks to the heart. Tell us about this concern.
Dr. McKinnon: Many people who take care of lupus patients, or even lupus patients themselves, recognize that the heart can be under attack. Inflammation of the lining of the heart, pericarditis or inflammation of the heart muscle itself. I think it's less widely recognized that coronary artery disease is also more common in lupus patients.
Conner: Doctor McKinnon, is it the case that women with lupus versus men with lupus are more at risk?
Dr. McKinnon: Both men and women with lupus are at increased risk of cardiovascular disease because of the inflammation. It was an increase in this risk that was most marked in the younger women. So, men have a higher risk in general than women. But this younger lupus population of women had the most increase in relative risk of events.
Conner: And given this scenario, what sort of cardiovascular screening or testing is typically recommended to assess an individual's risk, or really to be proactive about this risk?
Dr. McKinnon: I like to have preventive cardiologists involved early on after a patient is diagnosed with lupus. And what these preventative cardiologists do is they look at modifiable risk factors for cardiovascular disease. Some of the more familiar ones that we know about, like high blood pressure, high cholesterol, but they also can look at other risk factors. They sometimes do specialized lipid profiles. They look at markers of blood clotting or increased risk of clotting. And they do additional testing. Sometimes it's a stress testing or coronary artery calcification measurements, which can help assess cardiovascular risk.
Conner: Well, Doctor McKinnon, what actions can be taken then or lifestyle changes can be made to help reduce this cardiovascular risk for someone who does have lupus.
Dr. McKinnon: Well, following this preventive cardiology screening assessment, we typically recommend very aggressive risk factor modification of the things that we can control. For example, making sure that blood pressure is tightly controlled, that increased cholesterol is treated. Patients are on a heart healthy diet, get regular exercise to the best of their abilities, given their disease, and that they do have regular checkups to monitor these risk factors, making sure that we're doing a good job of controlling them.
Conner: Doctor McKinnon, thanks for this update about lupus.
Dr. McKinnon: Thanks for having me. Bobbi.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
