Roubille C
Département de médecine interne, CHU de Lapeyronie, Montpellier, France; Inserm, PhyMedExp, CNRS, CHRU Montpellier, université de Montpellier, Montpellier, France; Université de Montpellier, Montpellier, France.
Rev Med Interne. 2024 Apr;45(4):194-199. doi: 10.1016/j.revmed.2023.11.001. Epub 2023 Nov 18.
Patients with chronic inflammatory and autoimmune diseases are at increased cardiovascular risk, which is the cause of persistent excess mortality despite increasingly effective specific treatment of the inflammatory and/or autoimmune disease. This increased cardiovascular risk is multifactorial, associated with accelerated atherosclerosis related to systemic inflammation, but also secondary to traditional cardiovascular risk factors and to the therapies used to control systemic inflammation. This justifies a coordinated, personalized management of cardiovascular risk in patients with chronic inflammatory and autoimmune diseases, based not only on the treatment of their disease to achieve the lowest level of activity, but also on the screening and management of their cardiovascular comorbidities and modifiable cardiovascular risk factors.
患有慢性炎症和自身免疫性疾病的患者心血管风险增加,尽管对炎症和/或自身免疫性疾病的特异性治疗越来越有效,但这仍是持续超额死亡率的原因。这种增加的心血管风险是多因素的,与全身性炎症相关的动脉粥样硬化加速有关,但也继发于传统心血管危险因素以及用于控制全身性炎症的治疗。这证明了对慢性炎症和自身免疫性疾病患者的心血管风险进行协调、个性化管理是合理的,不仅要基于治疗其疾病以达到最低活动水平,还要基于对其心血管合并症和可改变的心血管危险因素进行筛查和管理。