The Overlooked Connection: Congestive Heart Failure in Black Women and Men Living with Lupus

Heart Function

Systemic lupus erythematosus (SLE), commonly known as lupus, is a chronic autoimmune disease that disproportionately affects African Americans—particularly women. While lupus is well-known for causing joint pain, fatigue, and kidney issues, one of the most serious yet under-discussed complications is congestive heart failure (CHF). For Black women and men with lupus, the risks are even higher due to overlapping health disparities and systemic barriers in healthcare.

Lupus and the Heart: A Dangerous Link Lupus increases the risk of cardiovascular disease significantly, primarily due to chronic inflammation, hypertension, and organ damage. Congestive heart failure occurs when the heart is unable to pump blood efficiently, which can lead to fluid buildup in the lungs, legs, and other tissues.

A study published in Arthritis & Rheumatology in 2021 found that people with lupus have nearly double the risk of developing heart failure compared to those without lupus. The risk is even greater in African Americans due to higher rates of comorbid conditions like hypertension and diabetes, and poorer access to quality care.

Black Women and Lupus: A High-Risk Population

• Black women are 3 to 4 times more likely to develop lupus than white women.

• They also tend to develop lupus at a younger age and with more severe symptoms.

• A 2022 CDC report noted that Black women with lupus had a significantly higher hospitalization rate for heart failure than any other demographic.

Black Men with Lupus: Rare but Severely Affected Although lupus is less common in men, Black men who develop lupus tend to have more aggressive disease progression and poorer outcomes.

• In a 2019 NIH study, Black men with lupus had a 2.5-fold higher risk of developing congestive heart failure compared to white men with lupus.

• The combination of underdiagnosis, late treatment, and socioeconomic disparities contributes to this elevated risk.

Contributing Factors to Heart Failure in Black Lupus Patients

• Hypertension and Diabetes: Both are more prevalent among African Americans and accelerate cardiovascular damage.

• Chronic Kidney Disease (Lupus Nephritis): Common in Black lupus patients and a known precursor to heart failure.

• Medication side effects: Long-term use of corticosteroids, often necessary in lupus management, increases risk of heart disease.

• Healthcare access: Systemic barriers, including delayed referrals to rheumatologists and cardiologists, exacerbate disease progression.

What Can Be Done?

1. Early and consistent screening for heart disease in lupus patients, especially in African American populations.

2. Education and awareness about heart failure symptoms such as shortness of breath, fatigue, and swelling.

3. Collaboration across specialties—rheumatologists, cardiologists, and primary care providers must work together.

4. Patient empowerment: Encourage self-advocacy and regular cardiovascular checkups for those with lupus.

Conclusion The intersection of lupus, race, and heart failure is a pressing public health issue. For Black women and men with lupus, the risk of congestive heart failure is not just a possibility—it’s a common and life-threatening reality. Addressing this challenge requires awareness, equity in care, and proactive prevention strategies.

Sources

• Centers for Disease Control and Prevention (CDC)

• National Institutes of Health (NIH)

• Arthritis & Rheumatology, 2021

• Lupus Foundation of America