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Rheumatology · Sjögren's disease

Does Sjögren's Disease Increase Heart Disease Risk?

At a Glance

Primary Sjögren's disease increases your risk of developing heart disease and atherosclerosis. This is because chronic systemic inflammation can irritate your blood vessels over time. Working proactively with your doctor to control inflammation and monitor your heart health can lower this risk.

Yes, having Primary Sjögren’s disease does increase your risk for developing heart disease and experiencing cardiovascular events like heart attacks [1][2]. This increased risk exists independently of traditional risk factors like age, weight, or smoking history [1][3]. While this can sound alarming, understanding the connection between autoimmune disease and your heart empowers you to take proactive steps to protect your cardiovascular health.

Primary Sjögren’s disease is a systemic disease, meaning it can affect your entire body, not just your moisture-producing glands. The underlying cause of this widespread effect is chronic, low-grade inflammation.

Over time, constant inflammation circulating in your bloodstream—particularly involving an inflammatory protein called Type I interferon—can irritate the inner lining of your blood vessels [4][5]. This ongoing irritation makes it easier for cholesterol and other substances to stick to the vessel walls, leading to a condition called atherosclerosis (a hardening and narrowing of the arteries) [4].

Studies have found that patients with Sjögren’s disease have a higher rate of subclinical atherosclerosis [6][2]. “Subclinical” means that plaque is slowly building up in the arteries before any physical symptoms of heart disease appear [6]. In fact, research suggests that the risk of early vascular damage in Sjögren’s disease may be comparable to the risk seen in people with type 2 diabetes [6][2]. However, exactly like diabetes, this risk is heavily modifiable with proper management.

How Your Medications Might Play a Role

While treating the inflammation of Sjögren’s is essential, some of the medications commonly used to manage flare-ups and joint pain can influence your heart health. Specifically, the frequent or long-term systemic use of corticosteroids (such as prednisone) and NSAIDs (non-steroidal anti-inflammatory drugs, like ibuprofen or naproxen) has been associated with an increased risk of developing coronary heart disease [7][8].

This does not mean you should stop taking your medications. Never stop taking corticosteroids abruptly without your doctor’s supervision, as doing so can cause a life-threatening adrenal crisis. Rather, it highlights why your rheumatologist and primary care doctor must work together to find the lowest effective dose of these medications to manage your symptoms while minimizing cardiovascular risks [8].

Taking Proactive Steps: Your Heart Health Checklist

Because Sjögren’s disease acts as an independent risk factor for heart disease [1][9], proactive cardiovascular care should be a core part of your long-term health management strategy. Do not wait for heart symptoms to appear; instead, focus on aggressive monitoring and management of the risk factors you can control:

  • Monitor Your Blood Pressure: High blood pressure puts extra strain on your blood vessels. Have it checked at every doctor’s appointment and consider tracking it at home.
  • Check Your Cholesterol and Blood Sugar: Ask your primary care doctor for an annual lipid panel to measure your LDL (“bad” cholesterol), HDL (“good” cholesterol), and triglycerides, along with a fasting blood glucose or HbA1c test for metabolic health.
  • Discuss Advanced Screenings: Because plaque buildup can happen silently, ask your primary care doctor or a cardiologist if you might benefit from specialized screenings, such as a carotid ultrasound or a coronary artery calcium (CAC) scan, to check for early signs of atherosclerosis.
  • Manage Lifestyle Factors: Prioritizing a heart-healthy diet and avoiding smoking can significantly lower your overall risk profile. For physical activity, respect the limitations of your disease—focus on gentle, joint-friendly movement tailored to your daily energy levels, rather than pushing through severe fatigue or pain.
  • Know the Warning Signs: Even with proactive care, always seek immediate medical attention if you experience acute cardiovascular symptoms like chest pain, shortness of breath, or unexplained jaw or arm pain.

Common questions in this guide

Does having Sjögren's disease mean I will get heart disease?
Having Sjögren's disease increases your risk for heart disease due to chronic inflammation, but it does not mean you will definitely develop it. Proactive management of your autoimmune condition and traditional heart health factors can significantly lower your risk.
How does inflammation from Sjögren's affect my arteries?
Constant inflammation circulating in your bloodstream can irritate the inner lining of your blood vessels. This irritation makes it easier for cholesterol to stick to vessel walls, leading to early plaque buildup known as subclinical atherosclerosis.
Can my Sjögren's medications cause heart problems?
Long-term or frequent use of certain medications like corticosteroids and NSAIDs can increase the risk of coronary heart disease. However, you should never stop these medications abruptly. Instead, work with your rheumatologist to find the lowest effective dose to manage your symptoms.
What tests should I get to check my heart health with Sjögren's?
You should regularly monitor your blood pressure, cholesterol, and blood sugar. Because plaque buildup can happen silently, you may also want to ask your doctor about advanced screenings like a carotid ultrasound or a coronary artery calcium scan to check for early signs of atherosclerosis.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Given my Sjögren's diagnosis, how often should I be screened for cardiovascular risk factors like high blood pressure and elevated cholesterol?
  2. 2.Could any of the medications I am taking to manage my Sjögren's, such as corticosteroids or NSAIDs, be negatively affecting my heart health?
  3. 3.Is my current Sjögren's treatment doing enough to suppress my systemic inflammation, or do we need to adjust it for my heart health?
  4. 4.Should I consider advanced screening for subclinical atherosclerosis, such as a coronary artery calcium scan, and should my primary care doctor or a cardiologist oversee this?
  5. 5.How can we safely balance managing my systemic inflammation with protecting my long-term heart health?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (9)
  1. 1

    Lipoprotein-associated phospholipase A2 and carotid intima-media thickness in primary Sjögren syndrome.

    Gültuna S, Can Sandıkçı S, Kaplanoğlu H, et al.

    Archives of rheumatology 2022; (37(1)):40-48 doi:10.46497/ArchRheumatol.2022.8838.

    PMID: 35949861
  2. 2

    Primary Sjögren's syndrome as independent risk factor for subclinical atherosclerosis.

    Novella-Navarro M, Cabrera-Alarcón JL, Rosales-Alexander JL, et al.

    European journal of rheumatology 2022; (9(1)):20-25 doi:10.5152/eurjrheum.2021.20093.

    PMID: 35110133
  3. 3

    Association between primary Sjögren's syndrome, cardiovascular and cerebrovascular disease: a systematic review and meta-analysis.

    Yong WC, Sanguankeo A, Upala S

    Clinical and experimental rheumatology 2018; (36 Suppl 112(3)):190-197.

    PMID: 29600936
  4. 4

    Trained Immunity in Primary Sjögren's Syndrome: Linking Type I Interferons to a Pro-Atherogenic Phenotype.

    Huijser E, van Helden-Meeuwsen CG, Grashof DGB, et al.

    Frontiers in immunology 2022; (13()):840751 doi:10.3389/fimmu.2022.840751.

    PMID: 35860283
  5. 5

    Composition and regulation of the immune microenvironment of salivary gland in Sjögren's syndrome.

    Tan Z, Wang L, Li X

    Frontiers in immunology 2022; (13()):967304 doi:10.3389/fimmu.2022.967304.

    PMID: 36177010
  6. 6

    Subclinical atherosclerosis in primary Sjögren's syndrome: comparable risk with diabetes mellitus.

    Zhang Y, Luo Q, Lu K, et al.

    Clinical rheumatology 2023; (42(6)):1607-1614 doi:10.1007/s10067-023-06538-3.

    PMID: 36813944
  7. 7

    The Ratio of Blood T Follicular Regulatory Cells to T Follicular Helper Cells Marks Ectopic Lymphoid Structure Formation While Activated Follicular Helper T Cells Indicate Disease Activity in Primary Sjögren's Syndrome.

    Fonseca VR, Romão VC, Agua-Doce A, et al.

    Arthritis & rheumatology (Hoboken, N.J.) 2018; (70(5)):774-784 doi:10.1002/art.40424.

    PMID: 29361207
  8. 8

    Increased risk of coronary heart disease among patients with primary Sjögren's syndrome: a nationwide population-based cohort study.

    Wu XF, Huang JY, Chiou JY, et al.

    Scientific reports 2018; (8(1)):2209 doi:10.1038/s41598-018-19580-y.

    PMID: 29396489
  9. 9

    The prevalence and relevance of traditional cardiovascular risk factors in primary Sjögren's syndrome.

    Bartoloni E, Alunno A, Valentini V, et al.

    Clinical and experimental rheumatology 2018; (36 Suppl 112(3)):113-120.

    PMID: 29998823

This page is for informational purposes only and does not replace professional medical advice. Always consult your rheumatologist or cardiologist about your specific cardiovascular risks.

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