Severe psoriasis increases cardiovascular mortality risk
MedWire News: Patients with severe psoriasis have an increased risk for mortality due to cardiovascular (CV) disease, study findings show.
The researchers also note that this association appears to be independent of traditional cardiovascular risk factors such as diabetes, hypertension, and hyperlipidemia.
“The results of this study demonstrate that patients with severe psoriasis have a clinically significant 57% increased risk of CV death,” Joel Gelfand, from University of Pennsylvania School of Medicine in Philadelphia, USA, and colleagues report.
“On the basis of our data, a patient with severe psoriasis has an excess risk of CV death attributable to psoriasis of one in 283 patients per year.”
The researchers used the General Practice Database to identify 3603 patients with severe psoriasis who were receiving systemic therapy consistent with severe psoriasis. CV mortality in these patients was compared with that in 14,330 patients without psoriasis. The cause of every death was determined from the electronic medical records.
Patients with severe psoriasis had a significantly higher frequency of deaths due to CV disease. The unadjusted overall risk for CV mortality per 1000 person-years was 8.75 in patients with severe psoriasis compared with 6.19 in individuals without the skin condition.
After adjusting for traditional CV risk factors, including age, gender, hyperlipidemia, hypertension, smoking, and diabetes severe psoriasis was found to be an independent risk factor for death due to CV disease, at a hazard ratio of 1.57.
Gelfand and colleagues note in the European Heart Journal that the relative risk for CV mortality was modified by age.
The relative risk for CV death was 2.69 for a 40-year-old with severe psoriasis, compared with 1.92 for a 60-year-old.
This suggests “a process of accelerated CV disease in younger severe psoriasis patients,” the researchers report.
“Therefore, it is of utmost importance that patients with severe psoriasis and their providers are aware of this increased risk and that these patients undergo appropriate risk assessment and implantation of prevention strategies.”
In a related editorial, Paul Ridker from Brigham and Women’s Hospital in Boston, Massachusetts, USA, suggested that otherwise healthy individuals with moderate-to-severe psoriasis should be “encouraged to follow lifestyle recommendations to include increased exercise frequency, dietary discretion, and smoking cessation.”
They should also “meet target goals for cholesterol and blood pressure consistent with those suggested for other ‘intermediate risk’ groups,” he added.
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By Lucy Piper