Psoriasis sufferers have an increased frequency of a variety of cardiovascular
risk factors including diabetes, obesity, high blood pressure, elevated blood
cholesterol levels, and smoking, results of a study confirm.
In particular, the
current results suggest that psoriasis is associated with key components of the
metabolic syndrome — a clustering of heart risk factors — and that this
association is stronger in cases of severe psoriasis.
This finding is
important, say the investigators, given that individuals with as few as one or
two metabolic syndrome risk factors are at heightened risk for death due to
cardiovascular disease.
“Our other studies
suggest that, independent of other risk factors, severe psoriasis itself may be
a risk factor for heart attack,” Dr. Joel M. Gelfand from the University of
Pennsylvania, Philadelphia told Reuters Health. “Therefore, patients with
psoriasis should be screened for cardiovascular risk factors, and if these risk
factors are present, they should be managed appropriately.”
Gelfand and
colleagues identified 127,706 patients with mild psoriasis and 3,854 with severe
psoriasis. Each psoriasis patient was matched to up to five psoriasis-free
control subjects.
Diabetes was present
in 7.1 percent of patients with severe psoriasis and in 4.4 percent of those
with mild psoriasis compared with just 3.3 percent of
controls.
High blood pressure
was present in 20 percent of patients with severe psoriasis, 14.7 percent of
those with mild psoriasis and 11.9 percent of controls. Elevated cholesterol or
“hyperlipidemia” was documented in 6 percent, 4.7 percent, and 3.3 percent,
respectively.
Nearly 20.7 percent
of individuals with severe psoriasis and 15.8 percent of those with mild
psoriasis were obese compared with roughly 13.2 percent of controls. Thirty-one
percent of those with severe psoriasis were smokers compared with 28 percent of
those with mild psoriasis and 20.7 percent of psoriasis-free
controls.
Compared with
controls, patients with mild psoriasis had higher adjusted odds of diabetes,
hypertension, hyperlipidemia, obesity, and smoking. Patients with severe
psoriasis had higher adjusted odds of diabetes, obesity, and
smoking.
Additionally,
diabetes and obesity were more prevalent in patients with severe psoriasis than
in those with mild psoriasis.
Patients with psoriasis should be encouraged to identify and manage
their modifiable cardiovascular risk factors, the authors conclude.