Factores de riesgo para aterosclerosis en enfermedades autoinmunitarias sistémicas

  • Ricardo Silvariño Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento Clínico de Medicina, Clínica Médica "C" Prof. Dra. Adriana Belloso, Asistente
  • Emilia Inoue Sato Brasil, Universidade Federal de São Paulo, Escola Paulista de Medicina, Reumatología, Profesora Titular
Palabras clave: ENFERMEDADES AUTOINMUNES, LUPUS ERITEMATOSO SISTÉMICO, ARTRITIS REUMATOIDE, ATEROSCLEROSIS, FACTORES DE RIESGO

Resumen

Los pacientes con enfermedades autoinmunitarias sistémicas (EAIS) presentan un riesgo incrementado de desarrollar aterosclerosis (AE). Esto responde a la presencia de factores de riesgo cardiovascular (FRCV) tradicionales –dislipemia, hipertensión arterial, diabetes, tabaquismo, obesidad, sedentarismo– y no tradicionales –actividad de la enfermedad, hiperhomocisteinemia, corticoterapia– que por diferentes caminos están incrementados. Los scores de riesgo cardiovascular absoluto no se mostraron útiles para predecir enfermedad cardiovascular en esta población, ya que al considerar solo los FRCV tradicionales subestiman el riesgo de futuros eventos. Las manifestaciones clínicas tienen características diferenciales que deben ser consideradas para no desestimarlas en la práctica clínica. El screening sistemático de los FRCV y la búsqueda de aterosclerosis subclínica deben estar dentro de la rutina de seguimiento de esta población. En ausencia de guías específicas y bajo el postulado que las EAIS imprimen un riesgo cardiovascular (CV) similar a la diabetes mellitus, los objetivos terapéuticos se asimilan a los propuestos para esta enfermedad. El control agresivo de los FRCV con medidas farmacológicas y no farmacológicas es el único camino capaz de reducir una de las principales causas de muerte en portadores de EAIS.

Citas

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Publicado
2008-06-30
Cómo citar
1.
Silvariño R, Inoue Sato E. Factores de riesgo para aterosclerosis en enfermedades autoinmunitarias sistémicas. Rev. Méd. Urug. [Internet]. 30 de junio de 2008 [citado 27 de septiembre de 2022];24(2):118-32. Disponible en: http://revista.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/583
Sección
Trabajos de Revisión o Actualización y Puestas al día