Evolving Approaches to Address Racial Disparities in Cardiovascular Outcomes Among SLE Patients

Evolving Approaches to Address Racial Disparities in Cardiovascular Outcomes Among SLE Patients

Black and Asian patients with systemic lupus erythematosus face significantly higher cardiovascular mortality and encounter heart disease events nearly two decades earlier than White peers.

Disparities in cardiovascular outcomes among patients with SLE demand urgent attention from rheumatology teams. The MDPI study on racial disparities demonstrates the heightened risks faced by Black and Asian patients, who exhibit significantly higher cardiovascular mortality than White cohorts—a gap driven by socioeconomic barriers and unequal access to preventive cardiology services. According to the 2020 American College of Rheumatology guidelines on cardiovascular risk management in SLE, routine risk assessment and early intervention are advised.

Compounding these challenges, Black SLE patients experience cardiovascular events nearly 20 years prior to their White counterparts, underscoring the need for earlier risk assessment and aggressive management of both traditional and disease-specific cardiovascular risk factors.

Such early onset deepens the management gap, as under-recognition and undertreatment of cardiovascular risk factors are pervasive, contributing to the observed disparities and leaving many minority patients without tailored surveillance or preventive measures that could substantially alter their cardiovascular trajectory.

Following these insights, clinical trials now emphasize inclusive enrollment to ensure therapeutic findings apply broadly. Diversity in clinical research is crucial to validate safety and efficacy across racial groups, aligning trial populations with the demographics of SLE. Per NIH’s Inclusion Across the Lifespan policy and FDA guidance on diversity in clinical trials, study designs should proactively recruit underrepresented populations.

Meanwhile, healthcare policies are being refined to enhance access to cardiovascular prevention and treatment for minority SLE patients through community-based screening programs, multidisciplinary care pathways bridging rheumatology and cardiology, and insurance reforms targeting financial barriers.

Key Takeaways:

• Black and Asian SLE patients face significantly higher cardiovascular risks and mortality.
• Cardiovascular events in Black SLE patients occur nearly two decades earlier than in White cohorts.
• Under-recognition and undertreatment of cardiovascular risk factors drive outcome disparities.
• Inclusive clinical trial enrollment and targeted policy reforms are essential for equitable care.