Response to the Letter to the Editor by Khullar and colleagues about our manuscript.

Cardiovascular involvement is measured by three items in the BILD index, so clearly it can play a role in overall levels of damage accumulation. However, efforts to unravel the impact of traditional versus SLE-specific risk factors remain challenging, and we are unable to examine these relationships with our current data. Moreover, we do not believe that the understanding of what drives cardiovascular disease in persons with SLE has progressed to the point to make this distinction more generally. This article is protected by copyright. All rights reserved.