Background: Cardiovascular risk is predominant in the population with systemic lupus erythematosus (SLE), which exhibits accelerated atherosclerosis. This process is influenced by SLE-specific risk factors as well as significant traditional risk factors such as hypertension, smoking, or obesity. Non-pharmacological interventions, such as physical activity and adopting an appropriate diet, play a major role in cardiovascular prevention in the general population.

Objectives: The aim of this work was to describe the dietary and physical activity habits of a cohort of lupus patients, as well as the prevalence of traditional cardiovascular risk factors (CVRFs).

Methods: Our work was based on a French multicenter prospective cohort study called Immune mediators and metabolites to stratify Systemic Lupus Erythematosus patients at high risk of cardiovascular diseases (ISLE), whose primary objective is to evaluate the prevalence of patients showing progression of carotid plaques or carotid Intima-Media Thickness (cIMT) after 18 months of follow-up. Patients, fulfilling the 2019 EULAR/ACR Classification criteria for SLE, were recruited during a consultation or hospitalization as part of the management of lupus disease and were assessed at baseline and after 18 months of follow-up. For this specific work, we analyzed the following data, all collected at baseline: arterial hypertension (defined as systolic blood pressure greater than or equal to 140 mmHg and/or diastolic blood pressure greater than or equal to 90 mmHg (single measurement) and/or current antihypertensive treatment); obesity (defined as a BMI greater than or equal to 30 kg/m²); dyslipidemia (defined as LDL cholesterol concentration greater than or equal to 4.1 mmol/L and/or HDL cholesterol concentration less than 1 mmol/L and/or triglycerides greater than or equal to 1.7 mmol/L); and the presence of active or non-active smoking. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), a self-administered questionnaire that records patients’ physical activity over the last 7 days to estimate the weekly time spent sitting, walking, and engaging in moderate or vigorous physical activity. Dietary habits were evaluated using the 14-item semi-quantitative Food Frequency Questionnaire (FFQ). This questionnaire was developed and validated within the French population to assess weekly intake of food groups likely to influence cardiovascular health: fruits and vegetables; saturated fatty acids derived from cheese, red meat, processed meat, quiches and pizzas, pastries, and butter; polyunsaturated Ω-3 and Ω-6 fatty acids and monounsaturated fatty acids derived from fish, fried foods, nuts, margarines, and oils. Each food group was assigned a score based on an evaluation grid. A negative score, ranging from 0 to -17, was attributed to the consumption of saturated fatty acids. A positive score, between 0 and +19, corresponded to the sum of the consumption of monounsaturated fatty acids, Ω-3 polyunsaturated fatty acids, and fruits and vegetables. Using scores from the different groups, the FFQ offered the advantage of obtaining an overall vascular risk dietary score called the Vascular Dietary Score (VDS), ranging from -17 to +19, and calculated as follows: VDS = Protective Score – Harmful Score = (Fruits and vegetables + monounsaturated fatty acids + Ω-3 polyunsaturated fatty acids) – (saturated fatty acids). The higher the VDS, i.e., closer to +19, the lower the cardiovascular risk of the diet. Conversely, the diet was considered at cardiovascular risk when the VDS was closer to -17.

Results: Baseline data from 141 patients included from March 2021 to January 2024 were analyzed. CVRFs were prevalent, with hypertension in 44.5% of the patients and dyslipidemia in about 27% of cases. Obesity accounted for 16% of the cohort, and overweight (BMI between 25 and 29.9 kg/m²) for 22%. Twenty percent of the cohort were active smokers, 28% were former smokers, and 52% were non-smokers. Patients engage in an average of 2.3 hours per week of vigorous physical activity. They engage in an average of 2 hours per week of moderate physical activity. Patients walk an average of 6.6 hours per week. We observed that less than half of the patients (42.9%) complied with international physical activity recommendations (engagement in at least 150–300 minutes of moderate-intensity physical activity, or at least 75–150 minutes of vigorous-intensity physical activity, or an equivalent combination throughout the week). Nearly one-third of the patients (31%) spent more than 6 hours per day sitting. About one-quarter of the patients had a dietary score in the two lowest quartiles, which is considered as deleterious in cardiovascular terms (Figure 1). Patients meeting the international physical activity recommendations appeared to be younger, spend less time sitting, and have a better dietary score.

Conclusion: In this preliminary study, we showed that less than half of the patients meet international physical activity recommendations, with nearly one-third spending more than six hours per day sitting. Approximately one-quarter of the patients have a VDS of 1 or lower, indicating a tendency toward a detrimental cardiovascular impact. Physical activity and a healthy diet can have benefits for the disease itself and its related symptoms, as well as for cardiovascular risk. Their implementation as part of the comprehensive management of patients through education of both practitioners and patients is crucial to prevent cardiovascular risk and is an integral part of the therapeutic approach to SLE.

REFERENCES: NIL.

Acknowledgements: Funding: FOREUM – Foundation for Research in Rheumatology.

Disclosure of Interests: Noémie Gensous Alnylam, Ghislain Rescoussier: None declared, Estibaliz Lazaro CSL Behring, NOVARTIS, SOBI, GSK, GILEAD, ViiV HEALTHCARE, AMGEN, SANOFI AVENTIS, ASTRAZENECA, Novartis, GSK, Gilead, SOBI, Astrazeneca, Christophe Richez ASTRAZENECA, BMS, NORDIC, PFIZER, JANSSEN-CILAG, SANOFI, BIOGEN, MSD, AMGEN, Lilly, CELLTRION, Galapagos, PFIZER, AbbVie, SANDOZ, MYLAN, AMGEN, MSD, Lilly, FRESENIUS KABI, GSK, ASTRAZENECA, NOVARTIS, CELLTRION, ROCHE SUISSE, JANSSEN-CILAG, AbbVie, Sophie Skopinski LEO Pharma, LEO Pharma, Patrick Blanco BMS, SANOFI-AVENTIS, Thierry Martin UCB PHARMA, BOEHRINGER, GSK, AMGEN, ASTRAZENECA, Otsuka, CHUGAI, BOEHRINGER, GSK, NOVARTIS, VIFOR, FRESENIUS KABI, Eric Hachulla ROCHE, CHUGAI, GSK, JANSSEN-CILAG, Alnylam, BOEHRINGER, ASTRAZENECA, Galapagos, SANOFI, BMS, IQVIA, BOEHRINGER, JANSSEN-CILAG, CHUGAI, SANOFI, GSK, NOVARTIS, ASTRAZENECA, MSD, Otsuka, BIOGEN, PFIZER, PAREXEL International, Sandrine Jousse-Joulin CHUGAI, JANSSEN-CILAG, Lilly, BIOGEN, ASTRAZENECA, Galapagos, SOBI, BOEHRINGER, GSK, NOVARTIS, ASTRAZENECA, CHUGAI, AbbVie, GSK, AbbVie, PAREXEL, Thomas Barnetche: None declared, Anna Kabala: None declared, Pierre Duffau Gilead, Otsuka, Servier, Novartis, Viela Bio, PAREXEL.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.