Determinants of Cardiovascular Disease among Urban Women with Psoriasis: A Case–Control StudyFunding Prajwalika scholarship stipend, Women in cardiology and related sciences (WINCARS), faculty 2019.
Background and Aim Psoriasis have a direct impact on development of cardiovascular risk factors leading to atherosclerosis and metabolic abnormalities. In order to prevent the complications, early and prompt identification of factors through various parameters help in primary and secondary prevention of cardiovascular diseases (CVDs) among these psoriatic patients. Therefore the aim of this study is to determine the prevalence of various determinants for cardiovascular diseases among cases and controls.
Methods A hospital based case control study at a tertiary care hospital included women from the out patient department, aged above 18 years who were known cases of psoriasis. 114 patients were recruited with 1:1 ratio between cases and controls. All patients were evaluated using semi structured interview schedule with socio demographic variables, duration of disease, family history, and usage of drugs. Severity of disease was assessed through the psoriasis area severity index (PASI). Body surface area (BSA), body mass index (BMI), waist circumference and blood pressure measurement were done using standard methods. Lipid profile, high sensitivity C-Reactive protein (HsCRP) and blood sugar through calibrated analyzers having quality control. Carotid intima media thickness (CIMT) was assessed by using carotid Doppler technique to measure atherosclerosis.
Results One hundred fourteen patients, means 57 pairs of cases and controls were analyzed in this study. Significant determinants among cases were raised such as waist circumference (p = 0.025), diastolic blood pressure (p = 0.0001), low density lipoprotein (p = 0.002) and fasting blood glucose (p = 0.004) when compared to controls. HsCRP and CIMT were also raised among cases but only CIMT was statistically significant when compared to controls (p = 0.0001). We also found raised determinants among psoriatic arthritis patients compared to psoriasis.
Conclusion Psoriasis patients had high waist circumference, diastolic blood pressure, low density lipoprotein, fasting blood glucose, and CIMT when compared to controls. Early identification of these determinants make them amenable for prevention.
27 July 2020 (online)
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
- 1 Farber EM, Nall ML. The natural history of psoriasis in 5,600 patients. Dermatologica 1974; 148 (01) 1-18
- 2 Naldi L. Risk factors for psoriasis. Curr Dermatol Rep 2013; 2: 58-65
- 3 Global psoriasis atlas-International federation of psoriasis. Available at: http://www.psoriasiscouncil.org. Accessed November 13, 2019 global-psoriasis-atlas
- 4 World Health Organization 2016. Global report on psoriasis. World Health Organization. Available at: https://apps.who.int/iris/handle/10665/204417
- 5 Naldi L, Svensson A, Diepgen T. et al European Dermato-Epidemiology Network. Randomized clinical trials for psoriasis 1977-2000: the EDEN survey. J Invest Dermatol 2003; 120 (05) 738-741
- 6 Balta I, Balta S, Demirkol S. et al Aortic arterial stiffness is a moderate predictor of cardiovascular disease in patients with psoriasis vulgaris. Angiology 2014; 65 (01) 74-78
- 7 Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 2007; 115 (04) 459-467
- 8 Singh S, Dogra S, Shafiq N, Bhansali A, Malhotra S. Prevalence of metabolic syndrome in psoriasis and levels of Interleukin-6 and tumor necrosis factor-αin psoriasis patients with metabolic syndrome: Indian Tertiary Care Hospital study. Int J Appl Basic Med Res 2017; 7 (03) 169-175
- 9 Alberti KG, Zimmet P, Shaw J. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome—a new worldwide definition. Lancet 2005; 366 (9491) 1059-1062
- 10 WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363 (9403) 157-163
- 11 Chobanian AV, Bakris GL, Black HR. et al National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National High Blood Pressure Education Program Coordinating Committee. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289 (19) 2560-2572
- 12 Kudligi C, Odugouda SG, Kuntoji V. Bhagwat PV, Asati DP, Dhayaneethi E, Kaivalyam. A clinical study of psoriasis and its association with co-morbid conditions. J Pak Assoc Dermatol 2016; 26 (04) 298-305
- 13 Owczarczyk-Saczonek AB, Nowicki RJ. Prevalence of cardiovascular disease risk factors, and metabolic syndrome and its components in patients with psoriasis aged 30 to 49 years. Postepy Dermatol Alergol 2015; 32 (04) 290-295
- 14 Landgren AJ, Bilberg A, Eliasson B. et al Cardiovascular risk factors are highly overrepresented in Swedish patients with psoriatic arthritis compared with the general population. Scand J Rheumatol 2019; 49 (03) 195-199
- 15 Milčić D, Janković S, Vesić S. et al Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based cross-sectional study. An Bras Dermatol 2017; 92 (01) 46-51
- 16 Vadakayil AR, Dandekeri S, Kambil SM, Ali NM. Role of C-reactive protein as a marker of disease severity and cardiovascular risk in patients with psoriasis. Indian Dermatol Online J 2015; 6 (05) 322-325
- 17 Kothiwala SK, Khanna N, Tandon N. et al Prevalence of metabolic syndrome and cardiovascular changes in patients with chronic plaque psoriasis and their correlation with disease severity: a hospital-based cross-sectional study. Indian J Dermatol Venereol Leprol 2016; 82 (05) 510-518