From the Research
Patients with Sjögren's syndrome have a significantly increased risk of cardiovascular disease, including atherosclerosis, myocardial infarction, and stroke, due to chronic systemic inflammation and traditional cardiovascular risk factors 1. The primary cardiovascular effects of Sjögren's syndrome include:
- Pericarditis
- Myocarditis
- Small vessel vasculitis
- Autonomic dysfunction leading to orthostatic hypotension and arrhythmias
- Accelerated atherosclerosis through chronic systemic inflammation
- Small vessel vasculopathy affecting coronary microcirculation, potentially causing angina
- Raynaud's phenomenon causing episodic vasospasm in extremities
The inflammatory nature of Sjögren's syndrome contributes to the development of cardiovascular disease, and patients often have a higher prevalence of traditional cardiovascular risk factors, such as:
- Hypertension
- Hyperlipidemia
- Diabetes
- Obesity
- Hyperuricemia
Management of Sjögren's syndrome should include:
- Regular cardiovascular risk assessment
- Aggressive treatment of traditional risk factors like hypertension and hyperlipidemia
- Appropriate immunosuppressive therapy to control underlying inflammation
- Consideration of hydroxychloroquine due to its immunomodulatory effects and favorable impacts on lipid profiles and glucose metabolism
- Monitoring for QT prolongation with certain medications and regular echocardiography if cardiac involvement is suspected
According to the most recent and highest quality study, extraglandular involvement, disease activity, inflammatory markers, and serologic markers such as anti-Ro/SSA and anti-La/SSB autoantibodies are associated with a higher risk of cardiovascular comorbidities in patients with Sjögren's syndrome 1.