Systemic lupus erythematosus and hypertension

• Published in: Autoimmunity reviews 2019-10, Vol.18 (10), p.102371, Article 102371
• Main Authors: Munguia-Realpozo, Pamela, Mendoza-Pinto, Claudia, Sierra Benito, Cristina, Escarcega, Ricardo O., Garcia-Carrasco, Mario, Mendez Martinez, Socorro, Etchegaray Morales, Ivet, Galvez Romero, Jose Luis, Ruiz-Arguelles, Alejandro, Cervera, Ricard
• Format: Article
• Language: English
• Subjects: Cardiovascular disease; Guidelines; Hypertension; Systemic lupus erythematosus
• ISSN: 1568-9972; 1568-9972
• DOI: 10.1016/j.autrev.2019.102371

Systemic lupus erythematosus (SLE) is associated with a high burden of cardiovascular disease (CVD), which is in part imputed to classical vascular risk factors such as hypertension. Hypertension is frequent among patients with SLE and studies show it is more prevalent in SLE patients than in people without SLE. Despite the high frequency of hypertension in SLE patients, the pathophysiological mechanisms underlying the development of hypertension remain poorly understood. 24-h ambulatory blood pressure monitoring has emerged as a valuable tool in determining blood pressure (BP) in SLE patients in whom hypertension has been associated with damage accrual, stroke and cognitive dysfunction. Although prevalent, current guidelines neglect the specific management of hypertension in SLE patients in their recommendations. This review discusses the mechanisms that may lead to hypertension and the literature evaluating hypertension screening and management in SLE patients. •Hypertension is highly prevalent in SLE.•Hypertension in SLE patients increases the risk of CVD.•The pathogenesis of hypertension in SLE is multifactorial.•Aggressive screening and low BP thresholds for anti-hypertensive treatment may be helpful.