Multiple studies suggest an increased risk of cardiovascular disease among patients with atopic eczema (AE) as compared to healthy controls, but there are limited data on which AE patients might be at highest risk. The objective of this study was to examine whether subtypes of AE based on patterns of disease activity from birth are associated with cardiovascular risk in mid-adulthood. We used data from the 1958 National Child Development Study and 1970 British Cohort Study, which are longitudinal cohort studies nationally representative of the United Kingdom (UK) population that follow over 17,000 individuals from birth. We assessed cardiovascular risk at age 46-50 using the QRISK3 score, which is a well-established cardiovascular disease risk score similar to the Framingham risk score developed for use in the UK. We compared cardiovascular risk (both a continuous score and a binary outcome of >5% risk) among 3 previously identified AE subtypes based on the course of self-reported symptoms at 5-8 time points since birth using regression models adjusted for sex, ethnicity, social class in childhood, and cohort. We found that individuals with AE were at increased cardiovascular risk compared to individuals with no AE, and the risk varied by AE subtype. There was no difference in cardiovascular risk relative to individuals with no AE for those in the 'decreasing' probability of AE over time subtype (OR 0.97, 95% CI 0.80-1.19), but the 'high' probability of AE over time (OR 1.62, 95% CI 1.27-2.06) and 'increasing' probability of AE over time (OR 1.94,) subtypes were associated with an increased likelihood of >5% risk of heart attack or stroke over the next 10 years. In conclusion, these data suggest cardiovascular risk is highest among those with increasingly active AE in adulthood, a newly identified AE subtype that warrants more attention in future research.
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