Sjögren’s disease is a chronic autoimmune disease that can affect the moisture-producing glands, commonly causing dry eyes and dry mouth, as well as other organs and systems throughout the body. Previous research suggests that people with Sjögren’s may also have an increased risk of cardiovascular disease. However, less is known about how often major cardiovascular events occur and which Sjögren’s-specific factors may contribute to this risk.
A new study titled, “Major adverse cardiovascular events in Sjögren’s disease: incidence, associated factors, and impact on mortality in a prospective multicenter cohort,” published in Rheumatology International in June 2026, followed people with Sjögren’s for nearly a decade to examine the occurrence of major cardiovascular events and identify associated risk factors.
Study Design
Type of study: Prospective, multicenter cohort study.
Who was included: 314 people with Sjögren’s disease who met 2002 American-European Consensus Group (AECG) classification criteria.
Where the data came from: Participants were part of the SJÖGRENSER registry of the Spanish Society of Rheumatology and were recruited from multiple centres across Spain.
Follow-up duration: Participants were followed for a median of 9.5 years.
What researchers measured: Researchers collected clinical, laboratory, Sjögren’s-specific, and cardiovascular information. They recorded traditional cardiovascular risk factors such as high blood pressure and dyslipidemia, as well as disease-related factors and medication use.
Primary cardiovascular outcome: Researchers examined major adverse cardiovascular events (MACE), defined as a non-fatal heart attack (myocardial infarction), non-fatal stroke, or death due to cardiovascular causes.
Researchers also explored how well SCORE2, an established tool used to estimate a person’s 10-year cardiovascular risk, predicted cardiovascular events in participants with sufficient data.
Key Findings
Approximately 5% of participants experienced a major cardiovascular event: During follow-up, 17 of the 314 participants (5.41%) experienced a major adverse cardiovascular event. These included 7 strokes (2.23%), 5 heart attacks (1.59%), and 5 cardiovascular deaths (1.59%).
Traditional cardiovascular risk factors were common: Dyslipidemia, which refers to unhealthy levels of cholesterol or other fats in the blood, was present in 33.1% of participants, while 26.4% had high blood pressure.
Several factors were associated with cardiovascular events: In exploratory analyses accounting for multiple factors, increasing age, glucocorticoid use (such as prednisone), and cryoglobulinemia were associated with a greater likelihood of experiencing a major cardiovascular event. Cryoglobulinemia occurs when abnormal proteins called cryoglobulins are present in the blood and can cause inflammation and damage to blood vessels.
Clinical Significance
This study highlights the importance of considering cardiovascular health as part of the long-term management of Sjögren’s disease. Although most participants did not experience a major cardiovascular event during the approximately 10-year follow-up period, cardiovascular risk factors such as high blood pressure and dyslipidemia were relatively common, and experiencing a major cardiovascular event was associated with substantially higher overall mortality.
The findings also suggest that cardiovascular risk in Sjögren’s may involve more than traditional risk factors alone. The association with glucocorticoid use (such as prednisone) also highlights the importance of periodically reviewing medication exposure and cardiovascular risk with healthcare providers. Disease-related factors, particularly cryoglobulinemia, may help identify individuals who require closer cardiovascular monitoring.
For people living with Sjögren’s, these findings suggest the need to carefully monitor modifiable cardiovascular risk factors, including blood pressure, cholesterol, smoking, physical activity, and other established aspects of cardiovascular health, alongside appropriate management of Sjögren’s disease.
Limitations and Future Directions
The study included a relatively small number of major cardiovascular events which limits the certainty of estimates for individual risk factors. In particular, associations involving glucocorticoid use and cryoglobulinemia should be confirmed in larger cohorts.
Future research should include larger and more diverse populations to determine whether Sjögren’s-specific factors can improve existing cardiovascular risk prediction tools. Further research may also help determine whether targeted cardiovascular screening and prevention strategies can reduce cardiovascular events and improve long-term outcomes for people living with Sjögren’s disease.
Reference
Rusinovich-Lovgach, O., Plaza, Z., Andréu, J. L., et al. (2026). Major adverse cardiovascular events in Sjögren’s disease: incidence, associated factors, and impact on mortality in a prospective multicenter cohort. Rheumatology International, 46, 122. https://doi.org/10.1007/s00296-026-06138-9
