TWO IMPORTANT features of the epidemiology of systemic lupus erythematosus (SLE) have become apparent in recent years. First, probably because of increased awareness and testing, the incidence of SLE appears to have tripled to 5.56 per 100 000 population, with an estimated prevalence of 130 per 100 000.1 Second, although the survival of patients with SLE has markedly improved, with 10-year survival rates of over 80%,1,2 mortality is still substantial. More than a third of all SLE deaths occur among persons younger than 45 years, and annual mortality has increased 1.6-fold over the last 2 decades.3 Many more patients suffer considerable morbidity and loss of quality of life. The major role of accelerated or "premature" atherosclerotic cardiovascular and cerebrovascular disease (ASCVD) in the morbidity and mortality of patients with SLE is now well established. Recently, new research has provided important insights into the scope and mechanisms of atherosclerotic vascular disease in lupus. Defining these advances may improve awareness, enable a more informed and effective therapeutic approach, and hopefully lead to better patient outcomes.
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