Cardiovascular disease associated with four dermatological inflammatory diseases
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Key takeaways:
- All inflammatory skin diseases were associated with higher risks for cardiovascular diseases.
- Patients with rosacea and alopecia experienced similar risks as patients with atopic dermatitis and psoriasis.
Patients with rosacea, alopecia areata, psoriasis or atopic dermatitis all face an elevated risk for cardiovascular disease, according to a study.
A growing body of evidence has found that inflammatory skin diseases (ISDs) are associated with an increased risk for comorbidities, many of which fall under the umbrella of cardiovascular disease (CVD).
“All of these ISDs have been identified as having a systemic inflammatory component in many patients, particularly those who are in the moderate to severe range,” Benjamin Ungar, MD, of the department of dermatology at Icahn School of Medicine at Mount Sinai, told Healio. “Increasingly, there is an understanding that chronic systemic inflammation can contribute to CVD.”
It has become well established that psoriasis and AD are associated with increased risk for CVD; however, there is less evidence to support the same risk in patients with rosacea and alopecia areata (AA).
In this cross-sectional, single-center study, Ungar and colleagues investigated the associations of CVD risk and elevated markers of inflammation in the blood of patients with rosacea and AA.
Adults with rosacea (n = 12,470) and AA (n = 2,970) were compared with adults with AD (n = 35,160) and psoriasis (n = 19,490). The total number of patients (n = 70,090) were also compared with the same amount of control participants that did not have any ISDs.
What the authors found is that patients with any of the four ISDs demonstrated consistently higher risks for CVD diagnoses with arterial disease being the most elevated risk.
Patients with rosacea had significantly higher odds of being diagnosed with one or more CVDs (OR = 1.67; CI, 1.58-1.77) compared with controls. Among the diseases with the highest risk were arterial disease (OR = 2.96; CI, 2.68-3.29) and hypertensive diseases (OR = 1.43; CI, 1.33-1.52) followed by cerebrovascular diseases (OR = 1.19; CI, 1.01-1.4).
Patients with AA were also at an elevated risk for all CVDs (OR = 1.4; CI, 1.21-1.62) including arterial disease (OR = 1.9; CI, 1.41-2.55) and hypertensive diseases (OR = 1.39; CI, 1.16-1.66) when compared with controls.
The study also confirmed what prior studies have found — patients with psoriasis or AD faced increased odds of being diagnosed with one or more CVD compared with those without psoriasis or AD (OR = 1.553; CI, 1.486-1.622 and OR = 1.34; CI, 1.27-1.41, respectively).
Interestingly, researchers found increased levels for markers of systemic inflammation across all four ISDs as well. Compared with healthy controls, patients with AA posed the highest risk for having erythrocyte sedimentation rate levels above the upper limit (OR = 4.61; CI, 2.83-7.5), whereas patients with psoriasis presented the highest odds of having elevated C-reactive protein levels (OR = 2.75; CI, 2.43-3.17).
“My hope is that this study increases recognition among dermatologists that these ISDs can be associated with increased CVD risk. This may lead to increased evaluation for CVD and/or referrals to internists and cardiologists to evaluate for CVD,” Ungar told Healio. “It will also hopefully be a reminder that ISDs can be systemic diseases that may necessitate systemic treatments.”