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 Psoriasis wasn't associated with higher risk of heart attacks or
strokes when people with the skin condition didn't have a family
history of cardiovascular disease, the study found.
But when people with mild psoriasis and a family history of major
adverse cardiac events like heart attacks and strokes were compared
to psoriasis sufferers without such a family history, their risk was
28 percent higher. With severe psoriasis and a family history of
heart problems, the risk was 62 percent higher.
"It is generally believed that patients with psoriasis are at
increased risk of cardiovascular disease due to the inflammatory
nature of psoriasis," said lead study author Dr. Alexander Egeberg
of the University of Copenhagen.
"While psoriasis itself may still confer an independent
cardiovascular risk compared with the general population, our
findings suggest that there may exist a genetic predisposition for
cardiovascular disease," Egeberg added by email.
To assess the link between psoriasis and a family history of heart
disease, Egeberg and colleagues reviewed Danish data from 1997 to
2011 on more than 2.7 million people, including almost 27,000
individuals with mild psoriasis and about 4,500 with severe
psoriasis.
At the start of the study, people were around 27 years old on
average.
Approximately two-thirds of those with psoriasis in the study had a
family history of cardiovascular disease, which was slightly more
common with severe psoriasis than with mild psoriasis.
Without a family history of heart disease, the rate of major adverse
cardiac events was 1.3 per 10,000 people per year among those who
didn't have psoriasis. That compared with 1.85 cases per 10,000
people per year with mild psoriasis and about 6 per 10,000 with
severe psoriasis.
But after researchers adjusted for other factors that might
influence the odds of heart attacks and strokes, they no longer
found a difference between people with psoriasis and the general
population when there was no family history of cardiovascular
disease.
There was, however, a significant difference in the risk of heart
attacks and strokes when people did have a family history of
cardiovascular disease, the researchers report in the Journal of the
American Academy of Dermatology.
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With a family history, the incidence rates of cardiac events were
about 18 per 10,000 people per year for the general population, 36
per 10,000 for mild psoriasis and 45 per 10,000 for severe
psoriasis.
One limitation of the study is that researchers excluded more than
2.6 million people who had incomplete data on family history in
Danish health registry records, which made the study population skew
younger, the authors note. This makes it unclear if the findings
would apply to people diagnosed with psoriasis later in life, the
authors said.
Even so, the findings suggest that doctors should be asking
psoriasis patients about their family histories, said Dr. Nehal
Mehta, chief of the inflammation and cardiometabolic diseases
section at the National Heart Lung and Blood Institute in Bethesda,
Maryland.
"The major take-home message from these findings should be for
providers to inquire about a family history of major adverse
cardiovascular events since it is also a cardinal risk factor for
future major adverse cardiovascular events in non-psoriasis
patients," Mehta, who wasn't involved in the study, said by email.
SOURCE: http://bit.ly/293hqoS Journal of the American Academy of
Dermatology, online June 7, 2016.
(Corrects journal name in the SOURCE line.)
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