Hypertensive Psoriasis Patients at Increased Risk of Cardiovascular Procedure and Operation

Patients who have psoriasis in combination with hypertension are more likely to undergo cardiovascular procedures or surgery than patients with hypertension alone, a new study concluded. 

Between 2005 and 2006, new-onset hypertension patients were identified using the Taiwan National Health Insurance Research Database. Patients with psoriasis (n = 4,039; 31.05% female; mean age, 58.08 years) were sex- and age-matched 1:1 with patients without psoriasis. Individuals who underwent cardiovascular procedure or surgery prior to the index date were excluded. 

After a mean follow-up of 5.62 years, psoriasis indicated an increased risk for cardiovascular procedure and surgery in hypertension patients (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.07–1.53). When using the “no psoriasis” cohort for reference, women had a greater risk of cardiovascular procedure or surgery than men (aHR, 1.52 vs 1.21), as did patients aged 50-64 years (aHR, 1.49; 95% CI, 1.10–2.03) when compared with older and younger patients. 

Severe psoriasis or psoriatic arthritis was associated with statistically insignificant higher risk of cardiovascular procedure and surgery compared with mild psoriasis (aHR, 1.22; 95% CI, 0.98–1.51) and no presence of psoriatic arthritis (aHR, 1.15; 95% CI, 0.84–1.58). 

The authors noted several limitations, including the reliance on administrative claims data and information from the register. They also did not have access to certain data, including specific surgery details and blood pressure. And while the researchers accounted for confounding factors, they also acknowledge unmeasured factors, including bodyweight, smoking, family history, physical activity, stress, and adherence to antihypertensive medication. 

Nevertheless, the researchers concluded, “The results suggested that hypertensive patients with concurrent psoriasis experienced an earlier and more aggressive disease progression of hypertension, compared with general hypertensive patients. Thus, patients with hypertension and psoriasis should be considered for more aggressive strategies for prevention of primary [cardiovascular disease, CVD] and more intense assessments for cardiovascular interventions needed to improve CVD outcome in these patients.” 

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Source: The Journal of Dermatology