Arterial Stiffness and Cardiovascular Risk Reclassification in Patients with Autoimmune Rheumatic Diseases.

Introduction: Autoimmune rheumatic diseases (ARD) increase the risk of early subclinical vascular damage such as arterial stiffness (AS), which is associated with cardiovascular events. It remains unclear whether this also occurs during clinical remission or low disease activity (CR/LDA).

Aims: We aimed to evaluate carotid-femoral pulse wave velocity (cf-PWV) in ARD-patients in CR/LDA and to compare them with a control group.

Methods: A cross-sectional study was conducted in Argentina (2022-2023). Group 1: ARD subjects in CR/LDA, without systemic organ involvement, office blood pressure (BP) <140/90 mmHg, and low 10-year cardiovascular risk (CVR) <5% according to WHO's calculator. Group 2: healthy controls.

Exclusion criteria: associated clinical conditions, evidence of target organ damage, presence of traditional cardiovascular risk factors, and use of antihypertensives, statins, or aspirin. cf-PWV was measured using the Aortic device.

Results: A total of 97 subjects were included: 48 ARD and 49 controls. Among those with high-normal BP: Group 1 showed higher cf-PWV (6.81±1.14 vs. 5.98±0.82 m/s, p<0.0001) and more AS (22/48 vs. 2/49, p<0.0001). In a sub-analysis restricted to subjects with normal-BP: Group 1 also showed higher cf-PWV and more AS (6.57±1.09 vs. 5.84±0.65 m/s, p=0.005; 14/36 vs. 0/37, p<0.0001). Among ARD patients the frequency of AS was 45.8% with high-normal BP and 38.8% with normal BP. Multivariate analysis showed that ARD and diastolic BP were independently associated with AS.

Conclusions: ARD patients in CR/LDA even with traditional low-CVR showed higher cf-PWV.