MODIFIABLE RISK FACTORS FOR ADVERSE OUTCOMES IN SLE

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The objective of this investigation is to prospectively confirm previously examined risk factors for adverse outcomes in Systemic Lupus Erythematosus (SLE). Modifiable risk factors have been shown to impact on both the disease activity, as measured by the SLAM as well as health status assessed by SF 36 in SLE. We aim to confirm that potentially modifiable risk factors such as self-efficacy and social support do effect disease activity (SLAM) and health status (SF36). Cardiovascular disease results in excess morbidity and mortality in young women with SLE. We plan to study the variation in cardiovascular risk factor management (risk factor detection and appropriateness of management according to published guidelines) in patients with SLE. We also plan to look at the association between cardiovascular risk factor management, SLE-specific factors, socio-demographic and psychosocial factors and: a) intermediate outcomes including smoking, hypertension, hyperlipidemia, sedentary lifestyle, obesity and diabetes; b) cardiovascular events including angina, myocardial infarction, congestive heart failure or stroke. The basic design of the proposed study is a prospective followup of 40 patients who were first evaluated between 1989 and 1994. Each patient will be asked to fill out a questionnaire by mail. After this, subjects will come to the clinic for a physician assessment of disease activity (SLAM). Disease activity will be measured 6 months later using the SA-SLAM and physical and mental health will be measured by the SF36. This will be filled out by mail with telephone or home visit followup for nonrespondents. Subjects will be asked to release all medical records regarding their care from all providers and hospitals since their diagnosis of lupus, and for relevant problems prior to diagnosis. The records will be reviewed for cardiovascular risk factors.