Could Psoriatic Arthritis Increase CVD Risk?

A significant number of patients with psoriatic arthritis develop cardiovascular events, and the predictors include both traditional risk factors, such as high blood pressure and diabetes, and the inflammatory features of the disease, according to a new study.

“We had previously demonstrated that patients with psoriatic arthritis are at increased risk for cardiovascular disease,” said study author Dafna D. Gladman, MD, FRCPC, professor of medicine at the University of Toronto. “This study is larger, and unlike our previous one, it looked at specific cardiovascular outcomes. The results are not surprising but certainly confirmatory.”
_____________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Examining the Link: Systemic Manifestations Associated with Psoriasis
Smoking Compounds Psoriatic Arthritis
_____________________________________________________________________________________________________________________________________________________________________

The researchers conducted a cohort analysis of 1091 patients followed from 1978 to 2013 in a large psoriatic arthritis clinic. A considerable proportion of them developed a cardiovascular event: 19.8% by age 70 and 30.1% by age 80.

In multivariate analysis, they found hypertension (relative risk (RR) 1.81, p=0.015), diabetes (RR 2.72, p<0.001), and the number of dactylitic digits (RR 1.20, p<0.001) to be independent predictors of major cardiovascular events. In women, sedimentation rate also was a significant predictor (RR 1.83, p=0.02).

“The most important message is that patients with psoriatic disease are at risk for cardiovascular disease,” Gladman said. “Therefore, not only do their traditional risk factors need to be addressed, but their psoriatic disease needs to be controlled. It is for that reason we recommend patients with psoriasis be screened for the presence of psoriatic arthritis—which affects 30% of patients with psoriasis, so their disease can be adequately treated.”

She will continue her research by trying to identify evidence of cardiovascular disease early using carotid ultrasound and looking at biomarkers for cardiovascular disease in her patients.

-Mike Bederka

Reference:

Eder L, Wu Y, Chandran V, Cook R, Gladman DD. Incidence and predictors for cardiovascular events in patients with psoriatic arthritis. Ann Rheum Dis. 2015 Oct 22 [epub ahead of print]. DOI: 10.1136/annrheumdis-2015-207980.