Autoimmunity, estrogen, and lupus

Autoimmune diseases are typically associated with an increased risk of cardiovascular disease. Most diseases of autoimmune origin typically present with increased prevalence toward one sex, for example, Systemic Lupus Erythematosus (SLE) is nine times more prevalent in women than men. Sex hormones and chromosomes have been implicated in the pathogenesis and course of autoimmune diseases, and may likewise influence cardiovascular disease associated with autoimmune disease. This chapter explores theories of autoimmunity and how these theories relate to sex, details concerning how SLE typically presents throughout the female lifespan, and then concludes with a summary of cardiovascular sequelae associated with SLE and other autoimmune diseases. Ultimately, SLE is notorious among autoimmune diseases for its overwhelming skew toward females, its wide range of systemic morbidities, disease flares that occur in conjunction with pregnancy, and the unusually high prevalence of hypertension in reproductive-age women, who are normally protected from cardiovascular disease.