Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1995 Oct;54(10):853–855. doi: 10.1136/ard.54.10.853

Increased prevalence of symptomatic macrovascular disease in systemic sclerosis.

D J Veale 1, T A Collidge 1, J J Belch 1
PMCID: PMC1010024  PMID: 7492228

Abstract

OBJECTIVES--To determine the prevalence of symptomatic macrovascular disease, as defined by the World Health Organisation questionnaire for intermittent claudication, in patients with systemic sclerosis (SSc), and to compare the prevalence in this population with a cross sectional population study group reported in the Edinburgh Artery Study (EAS). METHODS--A group of 53 patients with a diagnosis of limited or diffuse systemic sclerosis were identified from our register. They were asked to complete the WHO questionnaire to establish the presence or absence of intermittent claudication. In addition, each patient's case notes were reviewed to establish the existence of definite peripheral vascular disease and to determine their risk factor profile. RESULTS--Forty six patients responded to the questionnaire, giving a response rate of 87%. Intermittent claudication was found in 10 SSc patients (21.7%) according to the questionnaire (two with diffuse and eight with limited SSc), compared with a prevalence rate of 4.6% for claudication in the EAS. Three SSc patients experienced clinical events attributable to occlusion of a major artery proven on angiography. Four patients had hypertension, there were three current and four ex-smokers, and two had increased total cholesterol. None of these patients had diabetes. CONCLUSIONS--This study demonstrated a greater prevalence of macrovascular disease in patients with SSc than had been found in a neighbouring population.

Full text

PDF
854

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barile L. A., Bravo G., Pizarro S. Large vessel arterial thrombosis in systemic sclerosis with antiphospholipid antibodies. J Rheumatol. 1990 Dec;17(12):1721–1722. [PubMed] [Google Scholar]
  2. Belch J. J. Raynaud's phenomenon: its relevance to scleroderma. Ann Rheum Dis. 1991 Nov;50 (Suppl 4):839–845. doi: 10.1136/ard.50.suppl_4.839. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Belch J. J., Veale D. J., Colleridge T. Large vessel disease in CREST. Ann Rheum Dis. 1993 Nov;52(11):837–838. doi: 10.1136/ard.52.11.837-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Belch J. J., Zoma A. A., Richards I. M., McLaughlin K., Forbes C. D., Sturrock R. D. Vascular damage and factor-VIII-related antigen in the rheumatic diseases. Rheumatol Int. 1987;7(3):107–111. doi: 10.1007/BF00270462. [DOI] [PubMed] [Google Scholar]
  5. D'Angelo W. A., Fries J. F., Masi A. T., Shulman L. E. Pathologic observations in systemic sclerosis (scleroderma). A study of fifty-eight autopsy cases and fifty-eight matched controls. Am J Med. 1969 Mar;46(3):428–440. doi: 10.1016/0002-9343(69)90044-8. [DOI] [PubMed] [Google Scholar]
  6. Fowkes F. G., Housley E., Cawood E. H., Macintyre C. C., Ruckley C. V., Prescott R. J. Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol. 1991 Jun;20(2):384–392. doi: 10.1093/ije/20.2.384. [DOI] [PubMed] [Google Scholar]
  7. Goldhaber S. Z., Manson J. E., Stampfer M. J., LaMotte F., Rosner B., Buring J. E., Hennekens C. H. Low-dose aspirin and subsequent peripheral arterial surgery in the Physicians' Health Study. Lancet. 1992 Jul 18;340(8812):143–145. doi: 10.1016/0140-6736(92)93216-a. [DOI] [PubMed] [Google Scholar]
  8. Kahan A., Devaux J. Y., Amor B., Menkès C. J., Weber S., Nitenberg A., Venot A., Guérin F., Degeorges M., Roucayrol J. C. Nifedipine and thallium-201 myocardial perfusion in progressive systemic sclerosis. N Engl J Med. 1986 May 29;314(22):1397–1402. doi: 10.1056/NEJM198605293142201. [DOI] [PubMed] [Google Scholar]
  9. Kallenberg C. G., Wouda A. A., The T. H. Systemic involvement and immunologic findings in patients presenting with Raynaud's phenomenon. Am J Med. 1980 Nov;69(5):675–680. doi: 10.1016/0002-9343(80)90417-9. [DOI] [PubMed] [Google Scholar]
  10. Merino J., Casanueva B., Piney E., Val Bernal F., Rodriguez-Valverde V. Hemiplegia and peripheral gangrene secondary to large and medium size vessels involvement in C.R.E.S.T. syndrome. Clin Rheumatol. 1982 Dec;1(4):295–299. doi: 10.1007/BF02032090. [DOI] [PubMed] [Google Scholar]
  11. Norton W. L., Nardo J. M. Vascular disease in progressive systemic sclerosis (scleroderma). Ann Intern Med. 1970 Aug;73(2):317–324. doi: 10.7326/0003-4819-73-2-317. [DOI] [PubMed] [Google Scholar]
  12. ROSE G. A. The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bull World Health Organ. 1962;27:645–658. [PMC free article] [PubMed] [Google Scholar]
  13. Shapiro L. S. Large vessel arterial thrombosis in systemic sclerosis associated with antiphospholipid antibodies. J Rheumatol. 1990 May;17(5):685–688. [PubMed] [Google Scholar]
  14. Walmsley D., Goodfield M. J. Evidence for an abnormal peripherally mediated vascular response to temperature in Raynaud's phenomenon. Br J Rheumatol. 1990 Jun;29(3):181–184. doi: 10.1093/rheumatology/29.3.181. [DOI] [PubMed] [Google Scholar]
  15. Wigley F. M., Wise R. A., Miller R., Needleman B. W., Spence R. J. Anticentromere antibody as a predictor of digital ischemic loss in patients with systemic sclerosis. Arthritis Rheum. 1992 Jun;35(6):688–693. doi: 10.1002/art.1780350614. [DOI] [PubMed] [Google Scholar]
  16. Youssef P., Englert H., Bertouch J. Large vessel occlusive disease associated with CREST syndrome and scleroderma. Ann Rheum Dis. 1993 Jun;52(6):464–466. doi: 10.1136/ard.52.6.464. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES