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a University
Department of Medicine, Ninewells Hospital and Medical School, Dundee
DD1 9SY, b Department of Rheumatology, Aberdeen Royal
Infirmary, Aberdeen, c Rheumatic
Diseases Unit, Department of Medicine, The University of Edinburgh,
Western General Hospital, Edinburgh
Correspondence to: Dr M Ho
Accepted for publication 6 September 1999
OBJECTIVE
To determine
if macrovascular disease is more prevalent in systemic sclerosis (SSc)
compared with unaffected subjects.
METHODS54 patients
with SSc (both limited and diffuse disease) and 43 unaffected control
subjects of similar age and sex were recruited. All subjects underwent
a basic screen for conventional atherosclerotic disease risk factors.
All had non-invasive vascular assessmentsthat is, carotid duplex
scanning and measurement of ankle brachial blood pressure indexto
identify the presence of asymptomatic peripheral vascular disease.
RESULTS33 of 52 (64%) patients had carotid artery disease compared with only 15 of 42 (35%) controls (p=0.007). Eleven (21%) of these patients had moderate
disease compared with only two (5%) controls (NS). Nine of 53 (17%)
SSc patients had evidence of peripheral arterial disease compared with
no controls. This result was also statistically significant (p=0.003).
There were no significant differences in the basic risk factor profile,
which included cigarette smoking, systolic and diastolic blood
pressure, cholesterol, trigyceride and glucose concentrations.
CONCLUSIONMacrovascular
disease is more common in SSc. Screening of these patients may allow
identification of "at risk" patients at an early stage and allow
the study of treatments to attenuate the high rate of cardiovascular
mortality in these patients.
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