Lupus isn’t often thought of as a heart health condition. The autoimmune disorder is most commonly associated with symptoms such as fatigue, joint pain, and a telltale rash.
However, people with lupus are at an increased risk for high blood pressure and high cholesterol, as well as complications of those conditions. In fact, the link between lupus and cholesterol is a serious concern, and treating high cholesterol is a key part of lupus treatment.
Lupus is an autoimmune condition. It occurs when your body’s immune system mistakenly attacks its own tissues, bones, and organs. Lupus can affect the whole body, including skin, blood cells, joints, brain, and heart.
People with lupus are at a higher risk for high cholesterol. They’re also at a higher risk for complications of high cholesterol than people without lupus.
This is an effect of inflammation. The constant inflammation of lupus causes stress and damage to the blood vessels, which leads to a faster buildup of plaque on the walls of blood vessels. This makes it harder for blood to travel through your body and can lead to a wide range of heart health complications.
Inflammation also affects how the body processes fats. It can slow down your metabolism and cause your body to store more fats. This can lead to increased cholesterol, especially bad, or LDL cholesterol.
Common lupus treatments, such as steroids, are known to raise cholesterol levels when taken in high doses. Additionally, the fatigue of lupus can lead to a sedentary lifestyle, and a lack of exercise is proven to raise overall cholesterol, raise levels of bad cholesterol, and limit levels of good, or HDL cholesterol.
Lupus causes a wide range of symptoms that can be different across different people with lupus.
Symptoms can fluctuate over time and might not look the same with every flare-up. Traditionally, people think of lupus symptoms such as:
- “butterfly” rash that covers the cheeks
- skin rashes
- joint pain
- skin lesions that get worse in the sun
- dry eyes
- chest pain
- shortness of breath
- memory loss
- fingers and toes that turn blue or white in cold temperatures or as a stress response
However, lupus causes many other symptoms. There are also heart and cardiovascular system symptoms associated with lupus. These include high cholesterol, along with:
Statins are the preferred treatment for high cholesterol and heart conditions. They’re often prescribed for people with lupus who have high cholesterol, or who are at risk for high cholesterol.
Recently, research has suggested that this standard approach might not be appropriate. A 2019 study found that statins were ineffective as a stand-alone cholesterol treatment for people with lupus. This appears to primarily be because the causes of high cholesterol are different in people with lupus than in people without lupus.
However, the results suggested that statins could be used alongside other cholesterol treatment options to help bring down cholesterol levels.
Currently, many people with lupus still take statins as part of an overall cholesterol treatment plan. Your doctor will likely also suggest other treatments, such as lifestyle changes, that can help manage your cholesterol. You’ll have frequent cholesterol testing while you take statins to ensure that they’re helping you and to monitor your overall progress.
You can take steps to help your cholesterol levels if you have lupus. There are many ways you can improve your good cholesterol and lower your bad cholesterol through lifestyle management. If you have lupus, your doctor will likely have some recommendations. They might also talk with you about lowering your dose of steroid medications or switching to a different inflammation-controlling medication.
Common lifestyle steps include:
- Getting regular exercise: It’s great for people with lupus to focus on activities that are easy on the joints, such as swimming, biking, and yoga.
- Following a low fat diet: Reducing fat can help you fight cholesterol and inflammation.
- Following a heart-healthy diet: A diet like the Mediterranean diet can help improve your heart health, fight inflammation, and improve your overall health.
- Quitting smoking: Smoking is damaging to heart health, but quitting can reduce your risk of heart attack, stroke, and other complications.
- Maintaining a healthy weight: Losing weight and sticking to a healthy weight can lower your total body fat and your total cholesterol.
- Reducing alcohol: Drinking less is good for your heart and your liver.
People with lupus are at an increased risk for high cholesterol and the complications of high cholesterol. The chronic inflammation caused by lupus slows down your metabolism and damages your blood vessels. Combined, these factors can cause a buildup of cholesterol and plaque on artery walls. Plus, lupus medications, and side effects of lupus, such as fatigue, can increase cholesterol even more.
Traditionally, high cholesterol is treated with statins, but recent research suggests they might not be the most effective treatment for people with lupus. Currently, statins are still prescribed to treat high cholesterol in lupus, and changes to lifestyle and medications are strongly advised.