PT - JOURNAL ARTICLE AU - George Stojan AU - Laurence S. Magder AU - Michelle Petri TI - Blood Pressure Variability and Age-related Blood Pressure Patterns in Systemic Lupus Erythematosus AID - 10.3899/jrheum.181131 DP - 2019 Jun 15 TA - The Journal of Rheumatology PG - jrheum.181131 4099 - http://www.jrheum.org/content/early/2019/06/11/jrheum.181131.short 4100 - http://www.jrheum.org/content/early/2019/06/11/jrheum.181131.full AB - Objective Despite the high prevalence of cardiovascular disease among patients with systemic lupus erythematosus, the relationship between age, blood pressure, and blood pressure variability (BPV) is not well understood. We studied visit-to-visit BPV, its relationship to age, clinical, demographic characteristics and its potential role as a cardiovascular risk factor in patients with SLE. Methods We analyzed systolic and diastolic blood pressure measures in our cohort using mixed effects regression models. From these models, we then obtained estimates of the mean blood pressure, the visit-to-visit standard deviation and the between-person standard deviation. The estimated means were compared to general population using data from the National Health Statistics Reports from 2001-2008. In addition, we examined the relationship between blood pressures (means, variances), patient demographic, clinical characteristics, and subsequent cardiovascular events. Results The mean systolic blood pressure (SBP) in SLE increased with age and was significantly higher in younger patients compared to the general population. BPV in systemic lupus was elevated across all age. BPV was significantly higher in African Americans, in patients with traditional cardiovascular risk factors, those with high disease activity, and in patients taking prednisone. Hydroxychloroquine was associated with significantly lower BPV. Within-person variability in diastolic blood pressure of ≥9mmHg was highly associated with cardiovascular events in a multivariate analysis. Conclusion Age-related blood pressure patterns in SLE differ from the general population. Increased visit-to-visit BPV is affected by many disease-specific and traditional cardiovascular factors. Increased diastolic BPV is highly associated with cardiovascular events in SLE.