Heart disease is a leading cause of death of people with lupus. Heart disease includes pericarditis (inflammation of the sac surrounding the heart), myocarditis (inflammation of the muscle tissue of the heart), endocarditis (inflammation of the tissue that lines the inner walls of the heart and the valves that separate the heart’s different chambers), and coronary heart disease (or atherosclerosis).
Coronary heart disease is when fatty deposits and immune cells buildup in the coronary arteries (blood vessels to the heart) and form plaques. This can lead to heart attack from acute blockage of blood flow to the heart.
It is thought that people with lupus have an increased risk for coronary heart disease because there are more likely to have hypertension from kidney disease or corticosteroid use, elevated cholesterol levels from corticosteroid use, type 2 diabetes from corticosteroid use, and sedentary lifestyle due to joint problems, fatigue, and/or muscle pain. However, people with lupus are more likely to develop coronary heart disease even after you control for these risk factors. The mechanism behind the increased risk for coronary heart disease is still not fully understood.
More than 90 percent of people with lupus are women and symptoms and diagnosis most often occur when women are between the ages of 15 and 44, their childbearing years. Estrogen production is much higher than in males and it is at its peak during childbearing years. Additionally, many women with lupus have more symptoms when their estrogen levels are high, during pregnancy and/or before menstrual periods. These trends suggest that estrogen could play a role in the pathogenesis of lupus.