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Cardiovascular risk factors in patients with plaque psoriasis: a systematic review of epidemiological studies

Authors


  • Sources

    Abbott France provided financial support for publication but took no further part in the project. The authors have no financial interest in the subject matter or materials discussed in the manuscript.

  • Conflicts of interest

    C. Paul has received research grants and has been a paid consultant of Abbott France; S. Aractingi has given conferences in symposia sponsored by Wyeth and has been a consultant for Abbott and Schering-Plough; the remaining authors declare no conflicts of interests.

*Correspondence: C Paul. E-mail: paul.c@chu-toulouse.fr

Abstract

Introduction  Many epidemiological studies have associated psoriasis with an increased risk of coronary artery disease, resulting from a higher prevalence of cardiovascular risk factors in psoriasis patients compared with unmatched controls. However, the results of epidemiological studies vary depending upon the populations studied. The aim of this systemic review was to evaluate the risk of diabetes, hypertension, dyslipidaemia and obesity in adults with plaque psoriasis. In addition, we assessed the relationship between the risk of cardiovascular risk factors and psoriasis severity.

Methods  A systematic search was performed on Pubmed, Cochrane and Embase databases, using the key-words ‘psoriasis’, ‘diabetes’, ‘hypertension’, ‘high blood pressure’, ‘dyslipidaemia’, ‘metabolic syndrome’ and ‘obesity’, during the period from 1980 to June 2009.

Results  The initial literature search identified 353 articles. The final selection included 18 cross-sectional case-control studies. An increased risk of metabolic syndrome was observed in psoriatic patients (OR = 1.3–5.92), and a trend for a higher risk of obesity (OR = 1.18–5.49), especially in patients with severe psoriasis. For hypertension, hypertriglyceridaemia, and diabetes, the association was not significant in all studies.

Discussion  There was important heterogeneity in study design preventing from pooling results. Most often lifestyle factors such as smoking, alcohol consumption, physical activities were not taken into account.

Conclusion  There is an increased risk of obesity and metabolic syndrome in psoriasis. For hypertension, diabetes and dyslipidaemia no consistency was found across studies. Prospective epidemiological studies with thorough recording of cardiovascular risk factors are required in psoriasis patients.

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