J A Kaye1, L Li, S S Jick. 1. Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, 11 Muzzey Street, Lexington, MA 02421, USA. jkaye@bu.edu
Abstract
BACKGROUND: Recent cross-sectional studies reported a higher prevalence of diabetes and other risk factors for cardiovascular disease in patients with psoriasis than in the general population. OBJECTIVES: To estimate the cumulative incidences of risk factors for myocardial infarction and other vascular diseases after a first recorded diagnosis of psoriasis and the hazard ratio (HR) for these conditions in patients with psoriasis compared with the general population. METHODS: We used the General Practice Research Database to conduct a cohort study of 44,164 patients with a first-time diagnosis of psoriasis and 219,784 nonpsoriasis comparison subjects psoriasis-matched on age, sex and index date. RESULTS: HRs were increased among patients with psoriasis vs. the comparison cohort for incident diabetes [HR 1.33; 95% confidence interval (CI) 1.25-1.42], hypertension (HR 1.09; 95% CI 1.05-1.14), obesity (HR 1.18; 95% CI 1.14-1.23) and hyperlipidaemia (HR 1.17; 95% CI 1.11-1.23). Patients with psoriasis also had higher risks of incident myocardial infarction (HR 1.21; 95% CI 1.10-1.32), angina (HR 1.20; 95% CI 1.12-1.29), atherosclerosis (HR 1.28; 95% CI 1.10-1.48), peripheral vascular disease (HR 1.29; 95% CI 1.13-1.47) and stroke (HR 1.12; 95% CI 1.00-1.25). CONCLUSIONS: Risk factors for cardiovascular disease as well as myocardial infarction and other vascular diseases occur with higher incidence in patients with psoriasis than in the general population. Further work is needed to investigate whether these associations involve causal factors related to psoriasis or its treatment.
BACKGROUND: Recent cross-sectional studies reported a higher prevalence of diabetes and other risk factors for cardiovascular disease in patients with psoriasis than in the general population. OBJECTIVES: To estimate the cumulative incidences of risk factors for myocardial infarction and other vascular diseases after a first recorded diagnosis of psoriasis and the hazard ratio (HR) for these conditions in patients with psoriasis compared with the general population. METHODS: We used the General Practice Research Database to conduct a cohort study of 44,164 patients with a first-time diagnosis of psoriasis and 219,784 nonpsoriasis comparison subjects psoriasis-matched on age, sex and index date. RESULTS: HRs were increased among patients with psoriasis vs. the comparison cohort for incident diabetes [HR 1.33; 95% confidence interval (CI) 1.25-1.42], hypertension (HR 1.09; 95% CI 1.05-1.14), obesity (HR 1.18; 95% CI 1.14-1.23) and hyperlipidaemia (HR 1.17; 95% CI 1.11-1.23). Patients with psoriasis also had higher risks of incident myocardial infarction (HR 1.21; 95% CI 1.10-1.32), angina (HR 1.20; 95% CI 1.12-1.29), atherosclerosis (HR 1.28; 95% CI 1.10-1.48), peripheral vascular disease (HR 1.29; 95% CI 1.13-1.47) and stroke (HR 1.12; 95% CI 1.00-1.25). CONCLUSIONS: Risk factors for cardiovascular disease as well as myocardial infarction and other vascular diseases occur with higher incidence in patients with psoriasis than in the general population. Further work is needed to investigate whether these associations involve causal factors related to psoriasis or its treatment.
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