Groundbreaking research reported at the annual meeting of the American College of Rheumatology indicates that a certain form of the normally “good” high density lipoprotein (HDL) cholesterol linked to cardiovascular health plays a counterproductive role in people with systemic lupus erythematosus (SLE) and rheumatoid arthritis, promoting atherosclerosis (hardening of the arteries) and heart disease in many of these individuals. The menacing HDL form is pro-inflammatory HDL (piHDL), according to research by Bevra H. Hahn, MD, Maureen McMahon, MD, and colleagues at the David Geffen School of Medicine at UCLA, and it can easily be measured and, most importantly, treated. Dr. Hahn is chief of the division of rheumatology, and Dr. McMahon is an assistant clinical professor of rheumatology. “Traditional risk factors for atherosclerosis--including high blood pressure, increased cholesterol levels, diabetes mellitus, older age and postmenopausal status--have proved ineffective for predicting atherosclerosis in SLE patients,” said Dr. Hahn, whose research is funded by the Lupus Research Institute (LRI). “Uncovering a potentially important role for pro-inflammatory HDL in the development of atherosclerotic disease in patients with SLE is an important first step toward developing strategies to prevent cardiovascular morbidity and mortality in these patients.” Dr. Hahn notes that “pro-inflammatory HDL, which is easily measured, may provide just the sign, known as a biomarker, to determine which patients are at increased risk. If this research is successful, in two years or sooner a test may be available to screen for piHD. According to Dr. Hahn, women with lupus are about 7 to 10 times more likely than women without the disease to suffer a heart attack or stroke--just a few of the myriad serious health problems confronting the estimated 1.5 million Americans with this chronic autoimmune disease. In lupus, the body attacks its own healthy tissues and organs in a repetitive cycle of flare-ups and remissions.
