A new study has found that women with certain autoimmune diseases have a higher risk of dying from heart-related issues like heart disease and stroke compared to men with the same conditions. This difference exists even though death rates from these diseases have been dropping for both men and women over the years.
Autoimmune diseases happen when the body’s immune system, which usually fights off infections, starts attacking its own tissues and organs. This can lead to damage and inflammation in different parts of the body. Around 27 million people in the United States—about 8% of the population—are living with autoimmune diseases, according to government data.
The study focused on three common autoimmune diseases: rheumatoid arthritis, lupus, and systemic sclerosis. Rheumatoid arthritis is a condition where the immune system attacks the joints, causing pain and swelling. Lupus is a disease where the immune system can attack many parts of the body, including the skin, kidneys, and brain.
Systemic sclerosis, also called scleroderma, is a rare condition that causes the skin and other organs to harden and tighten. Unlike multiple sclerosis, which affects the brain and spinal cord, systemic sclerosis primarily affects the skin, blood vessels, and digestive system.
Women are far more likely to develop these autoimmune conditions than men. According to the Centers for Disease Control and Prevention (CDC), women are up to three times more likely to have rheumatoid arthritis and about nine times more likely to develop lupus. Systemic sclerosis is also more common in women.
Researchers used data from the CDC’s Wide-ranging Online Data for Epidemiologic Research (WONDER) database to track deaths linked to cardiovascular disease among people with these three autoimmune conditions. They examined records from 1999 to 2020, covering a total of 127,149 deaths.
They found that death rates from heart-related issues like heart attacks and strokes did go down over the years for both men and women. However, women still had a higher death rate than men. For example, deaths among women dropped from 3.9 per 100,000 to 2.1, while for men, the rate went from 1.7 per 100,000 to 1.2.
The main causes of death for people with autoimmune diseases were strokes and coronary artery disease. Coronary artery disease happens when the blood vessels that supply blood to the heart become clogged or narrowed.
Interestingly, women were not only more likely to die from strokes and coronary artery disease, but they were also more than twice as likely to die from problems like irregular heartbeats or sudden cardiac arrest.
Looking more closely at the specific diseases, the study found that women with rheumatoid arthritis had a heart disease-related death rate of 1.8 per 100,000, which was three times higher than the rate for men.
For lupus, the rates were also higher for women, at 0.2 per 100,000 compared to 0.1 for men. The researchers could not make a clear comparison for systemic sclerosis because the numbers were too small.
The study was published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes on May 5. The researchers said that more work needs to be done to understand why women with these conditions face higher risks.
Dr. Issam Motairek, the lead author of the study and a medical resident at the Cleveland Clinic, emphasized that it’s important to study these differences between men and women to improve treatment for patients with autoimmune diseases.
He believes that by understanding the reasons for these differences, doctors could develop better ways to protect women from heart problems.
The researchers suggested that improvements in treatments for both autoimmune diseases and heart diseases might explain why the death rates have been going down over time. However, they also noted that the CDC’s data might not be entirely accurate because of possible errors in how deaths were recorded.
For example, some people may have had other health problems that contributed to their deaths, but the data did not include that information. The severity of the autoimmune diseases and the types of treatments used were also not detailed in the records.
Dr. Heba S. Wassif, a senior author of the study and director of cardio-rheumatology at Cleveland Clinic, pointed out that there are still many unanswered questions. For example, she said it is still not clear why women are at higher risk and what specific treatments could help reduce that risk.
She also mentioned that it is important to find out if heart disease behaves differently in people with autoimmune diseases. If so, it could be leading to unusual symptoms that doctors might miss, resulting in delayed diagnoses.
Wassif believes that as scientists learn more about how inflammation affects heart health, they should use that knowledge to create prevention strategies specifically for women with autoimmune diseases. This could help bring down the number of heart-related deaths and improve the quality of life for women living with these conditions.
The study highlights the need for more attention to the link between autoimmune diseases and heart health, especially for women. It suggests that doctors and researchers need to focus more on understanding these risks and finding better ways to protect women from heart-related complications.
If you care about heart health, please read studies about top 10 foods for a healthy heart, and how to eat right for heart rhythm disorders.
For more health information, please see recent studies about how to eat your way to cleaner arteries, and salt and heart health: does less really mean more?
The research findings can be found in Circulation: Cardiovascular Quality and Outcomes.
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