Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: A longitudinal data analysis

doi:10.1016/0002-9343(94)90151-1

The American Journal of Medicine

Volume 96, Issue 3, March 1994, Pages 254-259

https://doi.org/10.1016/0002-9343(94)90151-1 Get rights and content

Abstract

purpose: To determine the effect of prednisone dose and hydroxychloroquine dose on the coronary artery disease risk factors serum cholesterol level, mean arterial blood pressure, and weight in patients with systemic lupus erythematosus.

patients and methods: A longitudinal cohort study of 264 patients with systemic lupus erythematosus was conducted. For all patients in the cohort, serum cholesterol, mean arterial pressure, weight, prednisone dose, hydroxychloroquine dose, and other potential confounding variables were recorded at each visit. Regression analysis appropriate for longitudinal data was used to assess the effect of prednisone on serum cholesterol and mean arterial pressure. To assess the effect of prednisone on weight, patients' weights were compared 90 days before and after a 10-mg or 20-mg increase in prednisone.

results: A total of 3,027 patient visits were analyzed. In the regression model for serum cholesterol, a change in prednisone dose of 10 mg was associated with a change in cholesterol of 7.5 ± 1.46 (SE) mg% after adjustment for the other significant variables in the model, including sex, race, hydroxychloroquine dose, and proteinuria. In the regression model for hydroxychloroquine, the 200-mg and the 400-mg dose were both associated with lower serum cholesterol (8.9 ± 3.44 SE mg%). In the regression model for mean arterial blood pressure, a 10-mg change in prednisone dose led to a change in mean arterial blood pressure of 1.1 mm Hg after adjustment for age, weight, and antihypertensive drug use. A 10-mg increase in prednisone dose was associated with a mean weight change of 5.50 ± 1.23 (SE) lb.

conclusions: Changes in prednisone dose led to definable changes in risk factors for coronary artery disease, even after adjustment for other variables known to affect these risk factors. According to longitudinal regression analysis, hydroxychloroquine therapy was associated with lower serum cholesterol.

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¹: Dr. Petri is supported by the NIH FIRST Award HL 47080-01 and the Hopkins Lilly Clinician Scientist Award. The Hopkins Lupus Cohort has been supported by the Lupus Foundation of America and the Maryland Lupus Foundation.

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Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: A longitudinal data analysis

Abstract

Am J Med

Am J Med

JAMA

J Biol Chem

Am J Med

N Engl J Med

Outcome in systemic lupus erythematosus: a prospective study of patients from a defined population

Medicine

Fatal cardiac failure due to myocardial microthrombi in systemic lupus erythematosus

BMJ

Findings at necropsy in the heart of a patient with anticardiolipin syndrome

Br Heart J

Myocardial infarction caused by cardiac microvasculopathy in a patient with the primary antiphospholipid syndrome

Ann Intern Med

Cardiovascular disease-related knowledge and attitudes in a high-risk Australian population

Med J Aust

Cardiovascular disease-related knowledge and attitudes in a high-risk Australian population

Med J Aust