A study based on medical records from more than a quarter million adult patients found that African-American patients with connective tissue diseases such as lupus or rheumatoid arthritis were twice as likely as white patients to suffer from narrowed or atherosclerotic blood vessels, which increase the risk of a heart attack, stroke or death. The study, published Feb. 4, 2016, in the open access Nature journal, Scientific Reports, also showed that the prevalence of narrowed blood vessels in patients with connective tissues disease (CTD) was particularly high in young African-Americans. “These findings raise new questions about the links between inflammation, connective tissue diseases and atherosclerotic cardiovascular disease,” said study author Francis Alenghat, MD, PhD, assistant professor of medicine in the section of cardiology at the University of Chicago. “They point to differences in heart disease risk tied to systemic inflammation and modified by race and age.”

Alenghat queried de-identified charts from more than 287,000 African-American and Caucasian patients treated at the University’s medical center. He found 10 percent of the African-American patients suffered from atherosclerotic cardiovascular disease—defined as a heart attack, ischemic heart disease, angina, coronary artery disease or atherosclerotic disease of any artery. The prevalence was slightly lower, 8.4 percent, in Caucasians. When he tallied up patients with connective tissue disease—such as rheumatoid arthritis, lupus, scleroderma or dermatomyositis—there was a clear connection between CTD and increased risk of atherosclerotic cardiovascular disease. The 8,747 patients with some form of CTD were more likely to have cardiovascular disease, especially if they were African-American.

The association of CTD with atherosclerotic cardiovascular disease “was more prominent in African-Americans and in the young,” he said. African-Americans were also more likely than whites to have traditional risk factors for cardiovascular disease, with significantly higher levels of diabetes, smoking and hypertension. They also support the importance of controlling inflammation and identifying and addressing traditional cardiovascular risks factors. “If we were to view the current findings on the backdrop of contemporary cardiovascular risk calculators and statin guidelines, many patients with connective tissue disease could reasonably consider moderate-intensity statin therapy at age 35,” he said. The National Heart, Lung, and Blood Institute and the University of Chicago’s Center for Research Informatics and the Institute for Translational Medicine funded this study.