Usefulness of the Framingham Risk Score in Patients With Chronic Psoriasis

Psoriasis is a chronic inflammatory skin disease associated with increased cardiovascular morbidity and mortality. The Framingham risk score is a validated and composite measurement that predicts the absolute risk of developing major cardiovascular events at 5 and 10 years. The objective of this study was to estimate the Framingham cardiovascular risk score in patients with psoriasis. A cross-sectional study in 234 adult patients with psoriasis and 234 age- and gender-matched patients with skin diseases other than psoriasis was performed. The Framingham risk score includes age, gender, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, smoking status, and diabetes mellitus. Framingham risk score was significantly higher in patients with psoriasis than in controls at 5 years (mean +/- SD 5.3 +/- 4.4 vs 3.4 +/- 3.3,p <0.001) and at 10 years (11.2 +/- 8.1 vs 7.3 +/- 6.3, p <0.001). The risk was higher for patients >50 years of age. Patients with psoriasis were more frequently smokers and diabetics and had more commonly atherogenic dyslipidemia than controls (p <0.05). Presence of psoriasis was independently associated with a higher Framingham score (coefficient 1.6, 95% confidence interval [CI] 0.6 to 2.5, p = 0.001). There was no correlation between severity or duration of psoriasis and Framingham risk score (coefficient 0.009, 95% CI -0.02 to 0.04, p = 0.6; coefficient 0.02, 95% CI 0.007 to 0.04, p = 0.7, respectively). In conclusion, patients with psoriasis have an intermediate risk of developing major cardiovascular events and thus interventions aimed to correct modifiable cardiovascular risk factors are warranted. (C) 2010 Elsevier Inc. All rights reserved. (Am J Cardiol 2010;106:1754-1757)