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What Do You Know About Sjögren’s Syndrome and Heart Attack Risk?

Heart Attack Risk
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According to a new study, the autoimmune condition Sjögren’s syndrome (SjS) that causes dry eyes and dry mouth more than doubles your heart attack risk. With careful monitoring and lifestyle modifications, you can lower your chances of developing this serious complication.

Understanding SjS

In the early 1900s, Swedish physician Henrik Sjögren (SHOW-gren) was the first to describe a group of women whose dry eye and dry mouth symptoms accompanied chronic arthritis. Today, primary Sjögren’s syndrome occurs in people with no other rheumatological disease. Secondary SjS develops when you have another rheumatological disease, most often systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). Between 400,000 and 3.1 million adults have Sjögren’s syndrome. Research suggests that genetic factors and possibly viral infections may predispose people to developing this condition. SjS can affect people at any age, but symptoms appear between 45 and 55 usually. It afflicts 10 times as many women as men. If you have SjS, abnormal proteins are present in your blood. This suggests that your immune system, which should protect your body against infections and cancers, attacks your tissues instead. Inflammation damages glands that secrete fluids. Most often, it affects tear duct and saliva glands, decreasing tear and saliva production. Symptoms include irritation, a gritty feeling or painful burning in the eyes. Dry mouth may make eating dry foods difficult. In addition, dryness may occur in the nasal passages, throat, vagina and skin. Other typical complaints include swallowing difficulty and acid reflux.

Medical Complications of SjS

Decreased tears and saliva cause most Sjögren’s syndrome complications. Having dry eyes increases your risk of developing infections around your eyes and may damage your corneas. Dry mouth may increase dental decay, gingivitis (gum inflammation) and oral yeast infections (thrush) that may cause pain and burning. Less common are episodes of painful swelling in the saliva glands around your face. SjS can affect other parts of your body too. Even if you don’t have lupus or rheumatoid arthritis, you may experience pain and stiffness in your joints with mild swelling. Some patients suffer from numbness, tingling and weakness. The remaining effects occur rarely and can be difficult to diagnose. Due to inflammation in your small blood vessels (vasculitis), rashes may appear on your arms and legs. Inflammation also may affect your lungs, liver and kidney.

Cardiovascular Disease Becomes an SjS Complication

Researchers conducted the first general-population-based retrospective study of 1,176 people with Sjögren’s syndrome between 1990 and 2010. They matched each case for age, gender and calendar year with 11,879 non-SjS controls. The myocardial infarction (MI) incidence rate was 7.7 among SjS patients and 3.4 in the control group per 1000 patient-years. After adjusting for cardiovascular and medication risk factors, SjS patients’ multivariable rate ratio for MI was 2.36. Their MI risk was 3.6 times higher during the first year after diagnosis. The lead researcher reported that the acute inflammatory state within the first year of SjS diagnosis likely caused the increased heart attack incidence. It persisted up to five years following the initial diagnosis. Then the risk decreased over time with a 1.9 rate ratio after five years. For first-time strokes, the incident rate for 1,195 new SjS patients was 5.1 while it was 3.4 for the 11,983 non-SjS matched controls per 1000 person-years. The relative risk for heart attack and stroke was 2.2 for SjS patients, compared to 1.5 for the control group.

Medications Can Ease SjS Symptoms

Your doctor can prescribe Sjögren’s syndrome treatments to reduce your most bothersome symptoms. Medications include Cyclosporine Ophthalmic, a prescription eye drop that decreases inflammation and stimulates tear production. You may benefit from a prescription medication such as Salagen (Pilocarpine) that stimulates saliva flow.

Whole DietProtect Your Heart Health With a Whole Diet

Adjusting your diet can help control your cardiovascular disease risk that increases with Sjögren’s syndrome. A new study revealed that a whole diet approach focused on using olive oil over butter and cream while increasing the amounts of fruits, vegetables, nuts and fish is more effective in preventing cardiovascular disease than a low-fat, low-cholesterol diet. The researchers discovered that while low-fat diets may lower cholesterol, they aren’t as conclusive in reducing cardiac deaths. By analyzing major diet and heart disease studies from the last several decades, investigators found that participants who adopted a whole diet approach had a greater reduction in non-fatal myocardial infarction and cardiovascular death.

Exercise to Reduce Your Heart Disease Risk

Many patients ask Dr. Michael Ruddy of the Princeton HealthCare System if they need to spend a certain amount of time or exertion exercising to reduce their heart disease risks. Based on various studies exploring how exercise affects heart disease, he recommends a total of about an hour and a half of fast walking spread out over the course of a week. Start out by exercising about 35 to 40 minutes every two or three days. This is a safe and effective way to burn some calories and maintain at least a modicum of conditioning to help prevent future heart problems.

Plan for a Healthy Future

Now that you know inflammation affects both Sjögren’s syndrome and cardiovascular disease, are you ready to tackle another challenge? To strive for a heart-smart future, monitor your increased coronary artery disease risk with your doctor. Together, you can adjust your diet and target your exercise program to reduce your heart attack chances.

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