Risk of cardiovascular disorders in hidradenitis suppurativa patients: a large‐scale, propensity‐matched global retrospective cohort study

Abstract

BackgroundPatients with hidradenitis suppurativa (HS) often suffer from comorbid diabetes, metabolic syndrome, and hyperlipidemia and, therefore, are susceptible to the development of cardiovascular diseases (CVDs). Moreover, systemic inflammation plays a vital role in the development of atherosclerosis. The creation of atherosclerotic plaque is characterized by endothelial dysfunction driven by elevated concentrations of interleukin (IL)‐1, IL‐6, and IL‐18 among others, as well as tumor necrosis factor (TNF) alpha.MethodsThis study aimed to assess the risk of HS patients developing CVDs. We performed a large‐scale, propensity‐matched global retrospective cohort study analyzing the risk of development of CVDs in patients suffering from HS. The analysis included 144,100 HS patients with 144,100 healthy controls (HC). The cohorts were matched regarding demographics and history of diseases relevant to CVDs, e.g., diabetes, obesity, and nicotine dependence. A total of 90 cardiovascular disorders were identified. The identification of cardiovascular disorders was based on ≥1% appearance of the event, based on absolute numbers, in both cohorts.ResultsBefore the matching, HS patients displayed a higher frequency in excess weight or obesity (25 vs. 14.4%, respectively), nicotine dependence, and diabetes mellitus, but lower odds of primary hypertension in comparison to healthy controls. A total of 47 CVDs are associated with an increased risk of onset in HS patients. Although the highest hazard ratio (HR; 2.1; 95% CI: 1.95–2.269) was found for unspecified heart failure, the HS cohort was exceptionally predisposed to developing myocardial infarction (HR: 2.06; 95% CI: 1.88–2.27) and an acute embolism and deep vein thrombosis of the lower extremity (HR: 1.93; 95% CI: 1.74–2.14).ConclusionsThis is the most extensive study on the association of HS with CVDs. We demonstrated that HS patients are at significantly greater risk of developing various CVDs compared to matched controls, with heart failure being the most common one.

Hidradenitis suppurativa and cardiovascular diseases: A bidirectional Mendelian randomization study

“…Prior observational research has looked into the connection between HS and CVDs. 29 , 30 , 31 , 32 , 33 For instance, Reddy et al. 34 found that, compared with non‐HS patients, those with HS had a 21% increased risk of MI after adjusting for relevant cardiovascular risk factors.…”

Editor's Highlights – June 2024

“…Krajewski et al 4 explored the association between HS and increased cardiovascular risk in a large-scale, propensitymatched global retrospective cohort study. This study involving 144,100 HS patients and 144,100 healthy controls identified HS as an independent risk factor for various cardiovascular diseases, highlighting the systemic nature of the condition and its potential to affect organs beyond the skin.…”