Increased risk of vascular events in systemic lupus erythematosus: is arterial stiffness a predictor of vascular risk?

Patients with systemic lupus erythematosus (SLE) have an increased vascular morbidity and mortality. Several established vascular risk factors are more prevalent in this population but cannot fully explain the reported excess atherosclerotic burden. Emerging vascular risk factors may also contribute to the increased vascular risk in these patients although the evidence is limited and often conflicting. SLE-specific risk factors also play a role in the pathogenesis of atherosclerosis.Given the multifactorial aetiology of vascular disease in SLE, an integrated index of risk could be useful in the management of these patients. Arterial stiffness possibly represents such an index and accumulating data suggest an increased prevalence of arterial stiffness in SLE. Many factors play a role in the loss of arterial elasticity in this population, including both emerging and established vascular risk factors. Arterial stiffness may emerge as a useful index for risk stratification in SLE and has the potential to guide therapeutic decisions in these patients.