News: Psoriasis and cardiovascular risk factorsLately, two studies have placed focus on psoriasis and
cardiovascular risk factors. They conclude that psoriasis is associated
with multiple cardiovascular risk factors, but also, that psoriasis
alone, may be an independent risk factor for cardiovascular events.
Cardiovascular risk factors more prevalent in psoriatics
A UK population-based study (1) identified 128.000 patients with mild
psoriasis and 3854 with severe psoriasis. The risk factors studied were
diabetes, hypertension, hyperlipidemia, obesity and smoking.
The respective prevalence rates of these risk factors were
significant elevated in psoriatics compared to controls. Additionally,
diabetes and obesity were more prevalent in those with severe psoriasis
than with mild psoriasis. Thus CV risk factors are associated with
psoriasis, and also, as key components of the metabolic syndrome, more
strongly associated with severe psoriasis than with mild psoriasis.
Psoriasis an independent risk factor for myocardial infarction
A population-based case-control study (2), also in the UK, concluded
that patients with psoriasis have a significant increased risk of
myocardial infarction (MI) independent of traditional CV risk factors.
The study included more than 130 000 patients and five times as many
controls.
The risk was particular great for younger patients and for patients
with severe psoriasis. As patients got older, the risk seemed to go
down closer to baseline by the time they reached their 70s.
The risk of MI was significant in the psoriasis patients when
adjusting for the risk factors age, diabetes, MI history, dyslipidemia,
hypertension, sex, and smoking status. However, the patients with
psoriasis were significant more likely to have many cardiovascular risk
factors, such as diabetes, dyslipidemia, to have hypertension and to be
male and smokers.
Screen patients for risk factors
Summarised from these two studies, physicians who see patients with
psoriasis, particular young patients, should screen them for
cardiovascular risk factors and encourage patients to manage those of
the risk factors, which can be modified.
References:
Neimann
,
AL
et al.
Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol. 2006; 55: 829-835.
Gelfand, Joel M. et al. Risk of Myocardial Infarction in Patients With Psoriasis. JAMA. 2006; 296(14): 735-1741
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