Psoriasis and cardiovascular risk factors: A case-control study on inpatients comparing psoriasis to dermatitis

Background: Previous reports demonstrated an association between psoriasis and cardiovascular disease (CVD) risk factors. However, most of these studies were based on computerized databases of outpatient clinics, which, because of International Classification of Diseases, Ninth Revision coding issues, require validation of the diagnosis of psoriasis. Objective: We sought to study associations between psoriasis and CVD risk factors among psoriatic inpatients compared to inpatients with dermatitis: Methods: A case-control study was performed using computerized medical databases from the Department of Dermatology at Rabin Medical Center in Israel. Inpatients given the diagnosis of psoriasis were compared with inpatients given the diagnosis of forms of dermatitis for the prevalence of smoking, obesity, diabetes, hypertension, hyperlipidemia, and CVD. Logistic regression models were used for multivariate analyses. Results: The study included 1079 inpatients with psoriasis and 1079 age- and gender-matched inpatients with dermatitis (control patients). A multivariate logistic regression model demonstrated that psoriasis is an independent risk factor for diabetes (odds ratio [OR] 1.43; 95% confidence interval [CI] 1.17-1.75), hypertension (OR 1.31; 95% CI 1.09-1.58), obesity (OR 1.32; 95% CI 0.99-1.76), and smoking (OR 1.38; 95% CI 1.10-1.73). Development of CVD was not significantly associated with psoriasis when correcting for diabetes, obesity, and hypertension. Limitations: Our study group was composed of inpatients only, which may be biased toward more elderly patients with severe psoriasis who may have consumed systemic treatment including immunosuppressants. Conclusions: Our study supports previous reports of an association between psoriasis and CVD risk factors, suggesting that the inflammatory process in psoriasis, but not in dermatitis, may have a systemic impact resulting in development of CVD risk factors. (J Am Acad Dermatol 2012;66:252-8.)