When you’ve been diagnosed with Sjögren’s disease, it’s natural to spend a lot of time focusing on managing the most common symptoms like dry eyes and dry mouth. But this autoimmune disease can affect other parts of the body as well. Not only can it cause inflammation throughout your entire body, but it can also cause heart abnormalities in some people.

Researchers have found that Sjögren’s disease, like other rheumatic diseases such as lupus and rheumatoid arthritis, increases the risk of heart disease. Learning more about what heart disease is, how it develops, and what can be done to prevent it can help you proactively protect your cardiovascular (heart) health. Here’s what you need to know about heart disease and its connection to Sjögren’s.

What Is Heart Disease?

Heart disease, which is the leading cause of death in the U.S., is often a general term used by healthcare providers to describe conditions that can impact your heart. Some examples of these conditions include:

• Coronary artery disease (a disease that impacts blood vessels)
• Arrhythmias (irregular heartbeats)
• Congenital heart defects (heart conditions present at birth)
• Heart valve diseases

When you have Sjögren’s disease, there are several issues that can increase your risk of heart disease. These issues include hypertension (high blood pressure), atherosclerosis (a buildup of plaque), pericarditis (inflammation of the sac around the heart), and myocarditis (inflammation of the heart muscle). Damage to your heart valves, comorbidities like diabetes, and genetic abnormalities can also lead to heart disease.

Why Sjögren’s Disease Increases Heart Disease Risk

People with Sjögren’s disease often have an increased risk for heart disease and other cardiovascular issues. Some studies report a higher rate of cardiovascular involvement in people with Sjögren’s, but the exact number depends on what researchers count (for example, anything from mild changes on testing to more serious heart or blood vessel problems). Most of the time, the chronic inflammation from Sjögren’s negatively affects your heart and blood vessels and can lead to heart disease.

In Sjögren’s disease, the immune system — which normally protects you — becomes overactive and can damage healthy tissues. The inflammation it causes can affect your heart and the inside lining of your blood vessels. Over time, this damage can lead to a buildup of fatty deposits (called plaque) inside your arteries and make your blood vessels narrower.

When blood vessels narrow, it’s harder for blood — and the oxygen it carries — to flow through your body. Some research suggests people with Sjögren’s may have higher rates of early blood vessel changes linked to plaque buildup. This may be related to inflammation and to higher cholesterol or triglycerides in some people.

When this happens, your arteries may eventually have trouble contracting and expanding, which can lead to high blood pressure. Having high blood pressure, which is common with Sjögren’s, can lead to heart disease and other heart-related issues. If high blood pressure is left untreated, it can increase your risk for a myocardial infarction (heart attack) or cerebrovascular event (stroke).

Common Heart-Related Issues With Sjögren’s Disease

One of the most common heart-related issues people with Sjögren’s experience is high blood pressure. One survey found that 36 percent of people with the condition have high blood pressure. Other studies have found that it impacts 28 percent to 50 percent of people with Sjögren’s disease.

What’s more, about 16 percent of people with Sjögren’s have pulmonary (lung) complications or pulmonary hypertension. This is different from regular high blood pressure — pulmonary hypertension means high pressure in the blood vessels of the lungs. Over time this high pressure can strain the right side of the heart and can lead to complications like blood clots in the lungs, vasculitis, blood vessel abnormalities, and interstitial lung disease (lung inflammation).

Other heart-related issues associated with Sjögren’s disease that can lead to cardiovascular disease include:

• Endothelial dysfunction — Often considered an early marker for heart disease, endothelial dysfunction occurs when the lining of your blood vessels don’t function correctly and your blood vessels become more narrow.
• Atherosclerosis — This condition occurs when plaque builds up in your arteries, causing slower blood flow, blockages, and changes in blood pressure.
• Arrhythmias — There are several types of arrhythmias, or irregular heartbeats, including tachycardia (faster heartbeat than normal). About 16 percent of people with Sjögren’s experience tachycardia, which can contribute to heart disease.
• Atrioventricular block (or heart block) — This condition, which is an electrical issue, causes your heart to beat more slowly than it should. Sometimes it can cause symptoms like lightheadedness, and other times you might be asymptomatic (have no symptoms).
• Pericarditis and myocarditis — These heart issues impact how your heart pumps and are rare in people with Sjögren’s. Pericarditis is uncommon in Sjögren’s — some studies report it in around 1 percent of people, but estimates vary.

Many of these heart-related issues are caused by the chronic inflammation in your body, as well as uncontrolled associated issues like high blood pressure and high cholesterol. The inflammation and related damages to your heart and blood vessels can ultimately lead to a heart attack, stroke, or even heart failure.

Reducing Your Heart Disease Risk With Sjögren’s

While having Sjögren’s disease puts you at a higher risk for developing heart disease, this doesn’t mean that you have to accept it as a given in your life. You can take steps to prevent heart disease by adopting a heart-healthy approach to life.

Start by attending your medical appointments, sticking to your treatment plan, taking your medications as recommended — including those for high blood pressure and high cholesterol — and managing your Sjögren’s disease. Proper management of Sjögren’s disease can reduce inflammation in the body and lower risk of heart complications. For example, hydroxychloroquine, a drug frequently used in the treatment of the disease, has proven anti-inflammatory effects in people with Sjögren’s. The drug may also play a role in decreasing atherosclerosis and cardiovascular risks, but its effectiveness in preventing those conditions needs further study.

You can also take the following steps to further protect your heart health:

• Stay physically active within the guidelines provided by your healthcare provider.
• Avoid exercising to exhaustion, especially if you have been diagnosed with pulmonary hypertension.
• Eat a nutritious diet including plenty of fruits and vegetables, whole grains, lean proteins, and healthy fats.
• Limit your salt intake, and stay hydrated.
• Consider following a Mediterranean diet.
• Limit how much alcohol you drink.
• Quit smoking if you smoke, and avoid secondhand smoke.
• Manage your weight, especially if you have obesity.
• Find healthy ways to manage stress and practice relaxation techniques.
• Prioritize nightly sleep and aim for about seven hours a night.

Finally, talk to your rheumatologist or another healthcare provider about your heart disease risk. They will let you know which screening tests you need and how often you should be evaluated.

Join the Conversation

On MySjögrensTeam, people share their experiences with Sjögren’s disease, get advice, and find support from others who understand.

If you have been diagnosed with Sjögren’s, what’s one thing you have done to reduce your heart disease risk? Let others know in the comments below.