A systematic review and meta-analysis of the association between psoriasis and hypertension with adjustment for covariates

Duan, Xi; Liu, Junbo; Mu, Yunzhu; Liu, Ting; Chen, Yujuan; Yu, Ruichao; Xiong, Xincai; Wu, Tao

doi:10.1097/md.0000000000019303

Cited by 34 publications

(25 citation statements)

References 41 publications

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“… 28 A cohort study from the University of Toronto also showed a higher prevalence of HTN in PsA compared with patients with psoriasis only (OR 2.17, 95% CI 1.22–3.83) after adjusting for several demographic factors, psoriasis-related factors, medications, and comorbidities. 6 In a meta-analysis by Duan et al ., 29 the odds of HTN was higher than the general population only in severe psoriasis (OR 1.13, 95% CI 1.03–1.25), and not in mild psoriasis (OR 1.09, 95% CI 0.98–1.22). Therefore, an association with increased systemic inflammation is likely; and PsA is thought to be at the severe end of the psoriatic disease spectrum in general.…”

Section: Metabolic Disease In Psamentioning

confidence: 74%

Psoriatic arthritis and the association with cardiometabolic disease: a narrative review

Karmacharya

Ogdie

Eder

2021

Therapeutic Advances in Musculoskeletal

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Psoriatic arthritis (PsA) is associated with a higher burden of cardiometabolic disorders, such as hypertension, dyslipidemia, diabetes, obesity, and cardiovascular disease (CVD), compared with the general population. These comorbidities are associated with the severity of disease, and adversely affect treatment outcomes in PsA. Comorbidities lead to increased physician visits and medications for patients and make the selection and maintenance of therapies challenging for physicians. Moreover, CVD is a leading cause of mortality in PsA. Therefore, optimal management of PsA should include not only treating the skin and joint disease, but also identifying comorbidities early, and managing them to improve long-term outcomes. Further studies are needed to understand the complex mechanisms, interactions, and trajectories of cardiometabolic comorbidities in psoriatic disease. Plain Language Summary Psoriatic arthritis and the association with cardiometabolic disease Psoriatic arthritis (PsA) is associated with a higher incidence and prevalence of cardiometabolic comorbidities compared with the general population, and higher than psoriasis and other inflammatory arthritides, such as rheumatoid arthritis and other spondyloarthritides. Obesity and hyperlipidemia are associated with an increased risk of developing PsA. Cardiometabolic comorbidities in PsA are associated with more severe disease and a lower likelihood of response to therapy. Suggested approaches to improve screening and management of CVD in PsA include education of family physicians and relevant specialists, development of mechanisms to improve communication between the rheumatologists and primary care providers, and novel models of care, including interdisciplinary cardio-rheumatology clinics.

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Section: Metabolic Disease In Psamentioning

confidence: 74%

Psoriatic arthritis and the association with cardiometabolic disease: a narrative review

Karmacharya

Ogdie

Eder

2021

Therapeutic Advances in Musculoskeletal

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“…1 It presents with well-defined, red, scaly plaques that can be pruritic or painful and is associated with comorbidities including psoriatic arthritis, hypertension, obesity and diabetes. [2][3][4][5][6][7] Psoriatic inflammation is primarily T-helper (Th)17 and Th1-driven, and is mediated by cytokines such as tumour necrosis factor (TNF)-α, interleukin (IL)-17 and IL-23. [8][9][10][11] Systemic treatment options for severe psoriasis include broadly-acting oral immunomodulators, such as methotrexate and ciclosporin, and biologics, which are monoclonal immunoglobulin-G (IgG) molecules (with the exception of etanercept) targeting specific cytokines or receptors involved in psoriasis pathogenesis (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Biologics in Psoriasis: Updated Perspectives on Long-Term Safety and Risk Management

Al‐Janabi¹,

Yiu²

2022

PTT

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Biologics targeting Th1/Th17 cytokines have revolutionised psoriasis treatment. In addition to treatment effectiveness, it is important to define and understand the long-term risks of biologic therapy in order to guide therapy selection and minimise these risks for patients where possible. This review article summarises available evidence from trial data, observational studies and pharmacovigilance registries to explore key long-term risks of biologic treatment, and how these risks might be managed in clinical practice.

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“…Data from epidemiologic studies show that hypertension is more prevalent among psoriasis patients, and prevalence is associated with psoriasis severity [ 19 , 26 – 28 ]. A recently published meta-analysis demonstrates that psoriasis is associated with an increased risk of hypertension compared with those without psoriasis [ 29 ].…”

Section: Association Between Psoriasis and Cardiovascular Risk Factormentioning

confidence: 99%

Psoriasis and Cardiovascular Risk: A Comprehensive Review

Masson

Lobo²,

Molinero³

2020

Adv Ther

117

129

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Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. Individuals with psoriasis have an increased risk of developing other chronic health diseases such cardiovascular disorders. The high incidence of cardiovascular events in the population with psoriasis could be explained by several mechanisms. The high prevalence of traditional cardiovascular risk factors and metabolic abnormalities contributes to the high cardiovascular burden in patients with psoriasis. Likewise, the presence of systemic inflammation in combination with metabolic abnormalities may act in a synergistic manner to increase cardiovascular risk in these patients. This review focused on epidemiologic and clinical evidence linking psoriasis to cardiovascular risk factors and cardiovascular disease. We described the possible pathophysiological mechanisms that justify this association and analyzed the best way to stratify the cardiovascular risk in patients with psoriasis. We also described the usefulness of the therapies frequently used in cardiovascular prevention and analyzed the impact of the specific psoriasis medication on cardiovascular risk factors or major atherosclerotic events. Knowledge of the application of different cardiovascular prevention strategies could mean an advantage in performing the difficult task of estimating cardiovascular risk and treating cardiovascular risk factors in this particular group of patients.

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A systematic review and meta-analysis of the association between psoriasis and hypertension with adjustment for covariates

Abstract: Supplemental Digital Content is available in the text

Cited by 34 publications

References 41 publications

Psoriatic arthritis and the association with cardiometabolic disease: a narrative review

Psoriatic arthritis and the association with cardiometabolic disease: a narrative review

Biologics in Psoriasis: Updated Perspectives on Long-Term Safety and Risk Management

Psoriasis and Cardiovascular Risk: A Comprehensive Review

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