Heart risk factors prevalent in psoriasis patients

NEW YORK (Reuters Health) - 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.

SOURCE: Journal of the American Academy of Dermatology, December 2006.