Helping Teens at High Risk for Early-Onset Heart Disease

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Juvenile systemic lupus erythematosus (JSLE) is an autoimmune disorder characterized by inflammation and damage in the joints, kidneys, and central nervous system, among other parts of the body. Juvenile dermatomyositis (JDM) is a rare inflammatory disease that causes muscle weakness and skin rash. Although all age and ethnic groups can be affected by the diseases, they often strike earlier in life, including during the teen years and sometimes even earlier.

In the long-term, JSLE and JDM can have serious health consequences, as these patients have unusually high rates of hypertension, chronic inflammation, and obesity. By young adulthood, people with JSLE and JDM have up to eight times higher risk of developing cardiovascular disease than their peers.

Exacerbating the issue are the high stress levels that often accompany these conditions. Fortunately, stress is a modifiable risk factor.

“There is an urgent need to develop and test intervention strategies for children with JSLE and JDM,” said lead investigator Kaveh Ardalan, MD, MS, a pediatric rheumatologist and researcher with Duke Health in North Carolina. “Children with JSLE and JDM need early interventions that change the trajectory of their cardiovascular health as they move through childhood, begin college, plan careers, and pursue personal goals.”

According to Dr. Ardalan, high stress and chronic inflammation in JSLE and JDM patients create a perfect storm of illness, inflicting significant damage on cardiovascular health and heart disease risk. At the same time, patients can address their disease with lifestyle modifications, including stress reduction. This research project is designed to help accomplish this goal, helping us understand how stress affects inflammation and cardiovascular health in people with JSLE and JDM and searching for ways to develop stress reduction interventions.

When the study is complete, investigators plan to create a framework that explains how stress, inflammation, and cardiovascular health are interconnected in pediatric-onset rheumatic diseases with a goal of creating stress reduction interventions that can improve both emotional and cardiovascular health.

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