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Framingham Risk Score underestimates cardiovascular disease risk in severe psoriatic patients: Implications in cardiovascular risk factors management and primary prevention of cardiovascular disease

Authors

  • Tiago Torres,

    Corresponding author
    1. Department of Dermatology, Centro Hospitalar do Porto, Porto, Portugal
    2. Medical School, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
    3. Unit for Multidisciplinary Investigation in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
    • Correspondence: Tiago Torres, M.D., Serviço de Dermatologia, Centro Hospitalar do Porto, Rua D. Manuel II, s/n, 4099-Porto, Portugal. Email: tiagotorres2002@hotmail.com

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  • Rita Sales,

    1. Medical School, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
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  • Carlos Vasconcelos,

    1. Medical School, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
    2. Unit for Multidisciplinary Investigation in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
    3. Department of Clinical Immunology, Centro Hospitalar do Porto, Porto, Portugal
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  • Berta Martins da Silva,

    1. Unit for Multidisciplinary Investigation in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
    2. Immunogenetics Laboratory, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
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  • Manuela Selores

    1. Department of Dermatology, Centro Hospitalar do Porto, Porto, Portugal
    2. Medical School, Instituto de Ciências Biomédicas Abel Salazar, University of Portugal, Porto, Portugal
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Abstract

Severe psoriasis has been associated with increase cardiovascular mortality, due to a higher prevalence of traditional cardiovascular risk factors and premature atherosclerosis, as a consequence of its systemic inflammation. Recently, it has been estimated that severe psoriasis may confer an increased 6.2% on long-term risk of cardiovascular disease based on Framingham Risk Score, which can have practical implications in the treatment of cardiovascular risk factors and primary prevention of cardiovascular disease, as treatment guidelines account for the risk of cardiovascular disease in treatment goals. The aim of this study was to analyze the influence of the attributable risk of severe psoriasis on long-term risk of cardiovascular disease and its implication on the correct treatment of cardiovascular risk factors and primary prevention of cardiovascular disease on a real-world cohort of patients. One hundred severe psoriasis patients without psoriatic arthritis or previous cardiovascular disease were evaluated and it was found that more than half of the patients were reclassified to a higher cardiovascular risk category with important clinical implications on the correct management of their cardiovascular risk factors and primary prevention of cardiovascular disease, as a considerable proportion of patients with hypertension, hypercholesterolemia and coronary heart disease equivalent risk were not being correctly managed.

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