Lupus can cause blockages in heart arteries (coronary artery disease, or CAD), leakage of heart valves, irritation of the outer layer of the heart, and even heart failure.

A 2013 review of data on cardiovascular disease and lupus found “at least 2- to 3-fold elevated risks of myocardial infarction, congestive heart failure, cerebrovascular disease, and overall CVD mortality” among individuals with lupus compared with the general population.

Ages 48-49 are most commonly affected by heart disease—almost a decade earlier than women without lupus.

Traditional risk factors are high cholesterol, high blood pressure, obesity, smoking, sedentary lifestyle, and diabetes. Lupus-specific risk factors for heart disease are older age at diagnosis, longer disease duration, and longer periods of steroid use. More active lupus, a history of kidney disease, the use of non-steroidal anti-inflammatory drugs (NSAIDs), and long-term use of cortico­steroids also increase risk.

The overall frequency of risk factors is higher in those with lupus, and the inflammation caused by lupus can affect the entire cardiovascular system. Also, women with lupus reach menopause on average four years earlier than women who do not have the disease, which is significant because they lose the cardioprotective effects of estrogen after that time.

Diet, regular exercise, and blood pressure and cholesterol control all help reduce the risk. For those with diabetes, it’s important to closely monitor blood sugar. Also, consider talking to your doctor about starting an aspirin regimen or taking hydroxychloroquine (Plaquenil®), which has been shown to be cardioprotective by lowering total cholesterol and blood glucose levels. Finally, because smoking causes a threefold higher risk of a heart attack when you have lupus, consider quitting.